临床护理路径在足踝部骨折手术患者护理中的应用效果

Application Effect of Clinical Nursing Pathway in the Nursing of Patients Undergoing Foot and Ankle Fracture Surgery

摘要: 探讨临床护理路径(Clinical Nursing Pathway, CNP)在足踝部骨折手术患者围手术期护理中的应用效果。方法：选取2023年1月至2024年1月我院收治的80例拟行手术治疗的闭合性足踝部骨折患者为研究对象，采用随机数字表法将其分为观察组与对照组，每组各40例。对照组实施骨科常规围手术期护理，观察组则依据制定的《足踝部骨折手术临床护理路径表》实施标准化、时序化护理。比较两组患者的平均住院日、住院总费用、术后并发症发生率、疼痛视觉模拟评分(VAS)、美国足踝外科协会(AOFAS)踝–后足功能评分及患者护理满意度。结果：观察组患者的平均住院日显著短于对照组[(8.5 ± 1.6)天 vs. (11.2 ± 2.1)天，P < 0.05]，住院总费用亦明显降低[(1.8 ± 0.3)万元 vs. (2.2 ± 0.4)万元，P < 0.05]。观察组总发生率为(5.0%)与对照组(12.5%) (P > 0.05)无明显统计学意义。术后第6 h、24 h、48 h、72 h，观察组患者的VAS评分均低于对照组(P < 0.05)。出院时及术后1个月随访，观察组的AOFAS评分均高于对照组(P < 0.05)。观察组的护理满意度评分[(96.2 ± 2.8)分]显著高于对照组[(88.5 ± 4.1)分] (P < 0.05)。结论：应用临床护理路径对足踝部骨折手术患者实施护理，能够有效优化围手术期管理流程，缩短住院时间，降低医疗费用，减少并发症，缓解术后疼痛，促进恢复，并提升患者满意度，具有临床推广应用价值。

Abstract: Objective: To explore the application effect of the Clinical Nursing Pathway (CNP) in the perioperative nursing of patients undergoing surgery for foot and ankle fractures. Methods: Eighty patients with closed foot and ankle fractures scheduled for surgery and admitted to our hospital from January 2023 to January 2024 were selected as the study subjects. They were randomly divided into an observation group and a control group using a random number table, with 40 patients in each group. The control group received routine orthopedic perioperative nursing, while the observation group received standardized, time-sequenced nursing based on the developed “Clinical Nursing Pathway Chart for Foot and Ankle Fracture Surgery.” The two groups were compared regarding average length of hospital stay, total hospitalization costs, incidence of postoperative complications, Visual Analogue Scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot functional scores, and patient nursing satisfaction. Results: The average length of hospital stay in the observation group was significantly shorter than that in the control group [(8.5 ± 1.6) days vs. (11.2 ± 2.1) days, P < 0.05], and the total hospitalization costs were also significantly lower [(1.8 ± 0.3) × 10,000 yuan vs. (2.2 ± 0.4) × 10,000 yuan, P < 0.05]. The overall complication rate showed no statistically significant difference between the observation group (5.0%) and the control group (12.5%) (P > 0.05). At 6 h, 24 h, 48 h, and 72 h postoperatively, the VAS scores of the observation group were lower than those of the control group (P < 0.05). At discharge and at the 1-month postoperative follow-up, the AOFAS scores of the observation group were higher than those of the control group (P < 0.05). The nursing satisfaction score of the observation group [(96.2 ± 2.8) points] was significantly higher than that of the control group [(88.5 ± 4.1) points] (P < 0.05). Conclusion: Applying the Clinical Nursing Pathway for nursing patients undergoing foot and ankle fracture surgery can effectively optimize the perioperative management process, shorten hospital stay, reduce medical costs, mitigate complications, alleviate postoperative pain, promote recovery, and enhance patient satisfaction. It holds value for clinical promotion and application.