文章摘要
谈晶,陈媛,刘洪娟,吴明珑.连续性护理干预在预防全髋关节置换术后下肢深静脉血栓形成中的应用价值.骨科,2019,10(1):63-67
连续性护理干预在预防全髋关节置换术后下肢深静脉血栓形成中的应用价值
Applied value of continuous nursing intervention for preventing the deep vein thrombosis of lower limbs after the total hip replacement
投稿时间:2018-03-22  
DOI:10.3969/j.issn.1674-8573.2019.01.012
中文关键词: 连续性护理干预  快速康复外科  全髋关节置换术  下肢深静脉血栓形成
英文关键词: Continuous nursing intervention  Fast-track surgery  Total hip arthroplasty  Deep vein thrombosis of lower limbs
基金项目:湖北省卫生健康委员会科研项目(WJ2017M060)
作者单位E-mail
谈晶 华中科技大学同济医学院附属同济医院骨科武汉 430030  
陈媛 华中科技大学同济医学院附属同济医院骨科武汉 430030  
刘洪娟 华中科技大学同济医学院附属同济医院骨科武汉 430030  
吴明珑 华中科技大学同济医学院附属同济医院骨科武汉 430030 1924212533@qq.com 
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中文摘要:
      目的 探讨连续性护理干预在预防全髋关节置换术(total hip arthroplasty, THA)后下肢深静脉血栓形成(deep venous thrombosis, DVT)中的应用价值。方法 选取2014年11月至2016年9月在我科行THA的198例病人作为研究对象,随机分为观察组(103例)和对照组(95例)。观察组采用融入快速康复外科(fast-track surgery, FTS)理念的连续性护理干预,对照组采用常规护理。通过汉密尔顿焦虑量表(Hamilton anxiety scale, HAMA)评分、疼痛视觉模拟量表(visual analogue scale, VAS)评分、Harris髋关节评分、下肢DVT发生率和病人护理服务满意率观察两组临床疗效。结果 两组术后的HAMA评分和VAS评分均较术前明显改善(P均<0.05);两组间HAMA评分和VAS评分比较,差异均有统计学意义(t=4.672,P<0.001;t=10.110,P<0.001)。术后6个月,观察组的Harris髋关节功能、疼痛、活动度和畸形评分均优于对照组,差异均有统计学意义(P<0.001,P<0.001,P<0.001,P=0.047)。观察组的病人护理服务满意率(95.15%)显著优于对照组(81.05%),差异有统计学意义(χ2=9.280,P=0.002);下肢DVT发生率(1.94%)显著低于对照组(9.47%),差异有统计学意义(χ2=5.343,P=0.021)。结论 连续性护理干预较常规护理模式,更能缓解病人焦虑、减轻疼痛、改善关节功能,显著减少下肢DVT的发生率,提高病人护理服务满意率,可作为行THA病人的护理选择。
英文摘要:
      Objective To explore the applied value of continuous nursing intervention for preven-ting the deep vein thrombosis of lower limbs after the total hip replacement (THA). Methods Total of 198 patients treated with THA were collected as the research objects from November 2014 to September 2016. All patients were randomly divided into control group (95 cases) and observation group (103 cases). Control group received routine nursing mode. The observation group received continuous nursing intervention with the concept of fast track surgery (FTS). Hamilton anxiety scale (HAMA) score, visual analogue scale (VAS) score, Harris hip score, patient satisfaction rate of nursing service and DVT incidence of lower limbs were used to observe the clinical efficacy of the two groups. Results After surgery, HAMA and VAS scores in two groups were significantly lower than those before surgery (P<0.05), and HAMA and VAS scores in observation group were significant lower than those in control group (t=4.672,P<0.001;t=10.110,P<0.001). Six months after surgery, the Harris hip joint scores (function, pain, range of motion and deformity) in the observation group were better than those in the control group (P<0.001, P<0.001, P<0.001, P=0.047). The satisfaction rate of nursing service in the observation group (95.15%) was significantly higher than that in the control group (81.05%) (χ2=9.280, P=0.002). The incidence of DVT in the lower limbs of observation group (1.94%) was significantly lower than that in the control group (9.47%) (χ2=5.343, P=0.021). Conclusion Compared to routine nursing mode, continuous nursing intervention was better in relieving anxiety and pain, improving joint function, reducing incidence of DVT of lower limbs, and improving satisfaction rate, which can be used as one nursing choice of patients with THA.
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