中医特色加速康复护理模式在老年股骨粗隆间骨折围手术期中的应用

Application of enhanced recovery after surgery nursing model with traditional Chinese medicine characteristics in perioperative period of intertrochanteric femoral fracture in the elderly

中文关键词: 老年  股骨粗隆间骨折  加速康复外科  围手术期  护理

英文关键词: elderly  intertrochanteric femoral fracture  enhanced recovery after surgery  perioperative period  nursing

中文摘要:

      目的 探讨中医特色加速康复护理模式在老年股骨粗隆间骨折患者围手术期中的应用效果.方法 选择2023年1月-2024年1月在苏州市中医医院接受手术治疗的60例老年股骨粗隆间骨折患者为研究对象,依据随机数表法分为对照组和观察组,每组30例.2组在相同治疗基础上,对照组实施常规护理模式,观察组实施中医特色加速康复(ERAS)护理模式.观察并比较2组患者治疗前后恶心呕吐、饥饿口渴、负性情绪及凝血功能变化情况.结果 术前,2组口渴/饥饿评分差异无统计学意义(P＞0.05);术后,2组饥饿、口渴评分均高于同组术前(P＜0.05),而观察组口渴/饥饿评分均低于对照组(P＜0.05).术前,2组恶心、呕吐情况均为0级;术后,2组恶心、呕吐程度与同组术前比较均有所增加(P＜0.001),而观察组恶心、呕吐程度较对照组减轻(P＜0.05).术前,2组SAS评分、SDS评分差异无统计学意义(P＞0.05);术后,2组SAS、SDS评分均高于同组术前(P＜0.05),而观察组术后SAS、SDS评分低于对照组(P＜0.05).术前,2组APTT、PT值差异均无统计学意义(P＞0.05);术后7 d,2组APTT、PT值均大于同组术前(P＜0.05),而观察组APTT、PT值均大于对照组(P＜0.05),且观察组术前后PT差值绝对值明显大于对照组(P＜0.05).结论 具有中医特色的加速康复护理模式干预下,可调节老年股骨粗隆间患者术后胃肠道功能,有效减少负性情绪出现,改善凝血功能,预防血栓形成,促进功能恢复.

英文摘要:

      Objective To explore the application effect of enhanced recovery after surgery(ERAS)nursing model with traditional Chinese medicine(TCM)characteristics in the perioperative period of elderly patients with intertrochanteric femoral fracture.Methods A total of 60 elderly patients with intertrochanteric fracture who underwent surgical treatment in Suzhou Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the research subjects.According to the random number table method,they were divided into control group and observation group,with 30 cases in each group.Both groups received the same treatment.The control group received routine nursing,and the observation group did ERAS nursing with TCM characteristics.The changes in nausea,vomiting,hunger,thirst,negative emotions,and coagulation func-tion were observed and compared between the two groups before and after treatment.Results Before the operation,there was no statistically significant difference in the scores of thirst/hunger between the two groups(P＞0.05).After the operation,the scores of hunger/thirst in both groups were higher than those in the same group before the operation(P＜0.05),while the scores in the observation group were lower than those in the control group(P＜0.05).Before the operation,the degrees of nausea and vomiting in both groups were grade 0.After the operation,the degrees of nausea and vomiting in both groups in-creased compared with those in the same group before the operation(P＜0.001),while the degrees in the observation group were significantly milder than that in the control group(P＜0.05).Before the operation,there was no statistically significant difference in the scores of SAS and SDS between the two groups(P＞0.05).After the operation,the scores of SAS and SDS in both groups were higher than those in the same group before the operation(P＜0.05),while the scores in the observation group were lower than those in the control group(P＜0.05).Before the operation,there was no statistically significant difference in the values of APTT and PT between the two groups(P＞0.05).After the operation,the values of APTT and PT in both groups were higher than those in the same group before the operation(P＜0.05),while the values in the observation group were higher than those in the control group(P＜0.05).Additionally,the absolute difference in PT values before and after the operation in the observation group was significantly greater than that in the control group(P＜0.05).Conclusion ERAS nursing model with TCM characteristics can alleviate postoperative gastrointestinal discomfort,reduces negative emotions,improves coagulation func-tion,prevents thrombosis,and promotes functional recovery in elderly patients with intertrochanteric femoral fracture.