股骨转子间骨折术后康复护理预防深静脉血栓形成及生活质量的研究

Study on Rehabilitation Nursing of Intertrochanteric Femoral Fracture to Prevent Deep Vein Thrombosis and Quality of Life

摘要: 目的：探讨围手术期规范化康复护理对转子间骨折患者术后下肢深静脉血栓(DVT)的预防作用及其对患者生活质量的影响。方法：选取2022年12月至2025年10月期间收治的124例转子间骨折手术患者，采用随机数表法分为试验组(n = 61)和对照组(n = 63)。对照组接受常规围手术期护理，试验组实施基于“围手术期全程干预 + 个体化适配”的规范化康复护理方案，包括术前健康教育、心理干预与功能储备，术后体位管理、阶梯式康复训练、并发症预防及出院后延续性指导。比较两组患者术后3个月的凝血指标(D-二聚体、纤维蛋白原、APTT、PT)、生活质量(SF-36评分)、护理有效率及并发症发生率。结果：干预后，试验组的D-二聚体、纤维蛋白原水平显著低于对照组(均P < 0.001)，APTT、PT显著高于对照组(均P < 0.001)；试验组SF-36各维度评分均显著优于对照组(均P < 0.001)；试验组护理总有效率为98.3%，显著高于对照组的68.3% (P < 0.01)；试验组总并发症发生率为4.9%，显著低于对照组的17.5% (P = 0.027)。结论：对转子间骨折患者实施围手术期规范化康复护理，能有效改善凝血功能、降低DVT等并发症风险，并全面提升患者生活质量，具有临床推广价值。

Abstract: Objective: To investigate the preventive effect of standardized perioperative rehabilitation nursing on postoperative lower extremity deep vein thrombosis (DVT) and its impact on the quality of life in patients with intertrochanteric fractures. Methods: A total of 124 patients who underwent surgery for intertrochanteric fractures between December 2022 and October 2025 were selected and randomly assigned using a random number table to either an experimental group (n = 61) or a control group (n = 63). The control group received conventional perioperative care, while the experimental group received a standardized rehabilitation nursing program based on “whole-process perioperative intervention + individualized adaptation”. This program included preoperative health education, psychological intervention, and functional preparation; postoperative position management, stepwise rehabilitation training, complication prevention; and post-discharge continuity of care guidance. Comparisons were made between the two groups regarding coagulation parameters (D-dimer, fibrinogen, APTT, PT), quality of life (SF-36 score), nursing effectiveness rate, and complication incidence at 3 months postoperatively. Results: After the intervention, the experimental group showed significantly lower levels of D-dimer and fibrinogen than the control group (both P < 0.001), and significantly higher APTT and PT than the control group (both P < 0.001). The experimental group also had significantly better scores across all dimensions of the SF-36 scale compared to the control group (all P < 0.001). The total nursing effectiveness rate was 98.3% in the experimental group, significantly higher than the 68.3% in the control group (P < 0.01). The total complication incidence was 4.9% in the experimental group, significantly lower than the 17.5% in the control group (P = 0.027). Conclusion: Implementing standardized perioperative rehabilitation nursing for patients with intertrochanteric fractures can effectively improve coagulation function, reduce the risk of complications such as DVT, and comprehensively enhance patients’ quality of life, demonstrating significant clinical value for promotion.