基于快速康复外科理念的护理干预对髋部骨折患者术后康复效果的影响

Effect of Nursing Intervention Based on the Concept of Rapid Rehabilitation Surgery on Postoperative Rehabilitation Outcomes in Patients with Hip Fractures

摘要: 目的：探讨基于快速康复外科(ERAS)理念的护理干预对髋部骨折患者术后康复效果的影响，为临床优化髋部骨折围手术期护理方案、提升患者康复质量提供依据。方法：选取2023年1月~12月新疆医科大学第六附属医院创伤骨一科收治的80例髋部骨折手术患者，按入院时间分为对照组与观察组，各40例。对照组采用围手术期常规护理，观察组采用ERAS理念指导的全程系统化护理，包括术前健康教育与优化准备、术中体温保护与情感支持、术后疼痛管理、渐进式营养支持及个性化早期康复训练。比较两组护理前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、术后恢复指标、疼痛视觉模拟评分(VAS)、生活质量、护理满意度及并发症发生率。结果：护理后，观察组SAS、SDS评分均显著低于对照组(P < 0.001)；观察组麻醉苏醒时间、术后首次排便时间、住院时间均短于对照组(P < 0.01)；观察组VAS疼痛评分低于对照组，生活质量评分高于对照组(P < 0.001)；观察组护理满意度95.0%，显著高于对照组72.5% (P < 0.01)；观察组并发症发生率7.5%，低于对照组20.0%，差异无统计学意义(P > 0.05)。结论：快速康复外科理念应用于髋部骨折患者围手术期护理，可有效缓解负性情绪、减轻术后疼痛、加快术后恢复、缩短住院时间、提高生活质量与护理满意度，具有良好临床应用价值。

Abstract: Objective: To investigate the impact of nursing interventions based on the Enhanced Recovery after Surgery (ERAS) concept on postoperative rehabilitation outcomes in patients with hip fractures, providing evidence for optimizing perioperative nursing protocols and improving rehabilitation quality in clinical practice. Methods: A total of 80 patients with hip fracture surgery admitted to the First Department of Trauma Orthopedics at the Sixth Affiliated Hospital of Xinjiang Medical University from January to December 2023 were selected and divided into a control group and an observation group based on admission time, with 40 cases in each group. The control group received conventional perioperative care, while the observation group received comprehensive systematic nursing guided by the Enhanced Recovery after Surgery (ERAS) concept, including preoperative health education and optimized preparation, intraoperative temperature protection and emotional support, postoperative pain management, progressive nutritional support, and personalized early rehabilitation training. The self-rating anxiety scale (SAS), self-rating depression scale (SDS) scores, postoperative recovery indicators, visual analog scale (VAS) pain scores, quality of life, nursing satisfaction, and complication incidence were compared between the two groups before and after nursing interventions. Results: After nursing intervention, the observation group showed significantly lower SAS and SDS scores compared to the control group (P < 0.001). The observation group also exhibited shorter anesthesia recovery time, first postoperative bowel movement time, and hospital stay than the control group (P < 0.01). The VAS pain score in the observation group was lower than that in the control group, while the quality of life score was higher (P < 0.001). Nursing satisfaction rate in the observation group was 95.0%, significantly higher than the control group’s 72.5% (P < 0.01). The complication incidence rate in the observation group was 7.5%, lower than that in the control group’s 20.0%, with no statistically significant difference (P > 0.05). Conclusion: The application of the rapid rehabilitation surgery concept in perioperative nursing for patients with hip fractures can effectively alleviate negative emotions, reduce postoperative pain, accelerate recovery, shorten hospital stay, improve quality of life and nursing satisfaction, demonstrating significant clinical value.