综合康复护理训练对老年下肢骨折术后患者 功能恢复的干预效果研究

Study on the Intervention Effect of Comprehensive Rehabilitation Nursing on the Functional Recovery of Elderly Patients with Lower Limb Fracture

摘要: 目的：探讨综合康复护理训练对老年下肢骨折患者术后功能恢复的临床效果。方法：采用单中心回顾性队列研究，纳入131例术后老年患者，分为常规康复组(71例)与综合康复护理组(60例)。综合康复组在常规训练基础上，实施由护士主导、多学科协作的系统性干预，包括本体感觉训练、平衡训练、心理支持与家庭康复计划等。比较两组干预前后的关节活动度、日常生活能力(MBI)、疼痛程度(VAS)及并发症发生情况。结果：干预后，两组患者的膝关节与髋关节活动度均较术前显著改善，但观察组的改善幅度显著大于对照组(P < 0.05)。在日常生活活动能力方面，两组患者的改良Barthel指数评分术后均有所提高，且观察组的评分显著高于对照组(P < 0.05)。疼痛评估显示，两组患者的视觉模拟评分均显著下降，观察组的疼痛缓解程度明显优于对照组(P < 0.05)。在并发症方面，观察组的总发生率低于对照组，但差异未达统计学意义(P > 0.05)；两组在术后患肢肿胀程度的改善上效果相近。结论：综合康复护理训练可有效提升老年下肢骨折患者术后关节功能、日常生活能力并缓解疼痛，是一种值得推广的术后康复干预模式。

Abstract: Objective: To investigate the effect of comprehensive rehabilitation training on the postoperative functional recovery of elderly patients with lower limb fracture. Methods: A single-center retrospective cohort study was conducted, enrolling 131 elderly patients postoperatively, who were divided into a conventional rehabilitation group (71 cases) and a comprehensive rehabilitation nursing group (60 cases). The comprehensive rehabilitation group received systematic interventions led by nurses and involving multidisciplinary collaboration, in addition to conventional training. These interventions included proprioceptive training, balance training, psychological support, and home-based rehabilitation programs. The range of motion, activities of daily living (ADL) (MBI), pain levels (VAS), and incidence of complications were compared between the two groups before and after the interventions. Results: After intervention, both groups showed significant improvement in knee and hip joint range of motion compared to preoperative levels, with the observation group demonstrating a significantly greater improvement than the control group (P < 0.05). In terms of daily activities of living (ADL), the modified Barthel Index scores improved postoperatively in both groups, with the observation group achieving significantly higher scores than the control group (P < 0.05). Pain assessment revealed a marked reduction in visual analogue scale (VAS) scores in both groups, with the observation group showing superior pain relief compared to the control group (P < 0.05). Regarding complications, the observation group exhibited a lower overall incidence rate than the control group, though the difference was not statistically significant (P > 0.05). Both groups demonstrated comparable outcomes in reducing swelling of the affected limb postoperatively. Conclusion: Comprehensive rehabilitation nursing training can effectively improve postoperative joint function, daily living ability, and alleviate pain in elderly patients with lower limb fractures, making it a recommended postoperative rehabilitation intervention model.