延续护理对老年转子间骨折患者术后生活质量及长期功能恢复的影响

The Impact of Continuous Care on Postoperative Quality of Life and Long-Term Functional Recovery in Elderly Patients with Intertrochanteric Fractures

摘要: 目的：为接受手术治疗的老年转子间骨折患者提供延续护理，并探讨其对生活质量及长期功能恢复的影响。方法：本前瞻性研究纳入了96例因转子间骨折入住我院骨科接受手术治疗的老年患者。根据随机数字表，将患者分为对照组和实验组(每组各48例)。对照组患者接受常规护理及出院指导，实验组患者除常规护理外还接受出院后持续护理。比较两组患者的髋关节功能(Harris髋关节评分)、生活质量(MOS 36项简明健康调查量表评分)、功能锻炼依从性、焦虑水平(自评焦虑量表评分)、抑郁程度(自评抑郁量表评分)、术后并发症以及出院后护理满意度。结果：与对照组相比，实验组在出院后3个月、12个月的Harris髋关节评分、身体功能、总体健康状况、社会功能、角色情感状态及心理健康方面的MOS 36项简明健康调查量表评分以及院外护理满意度均显著提高(P < 0.05)。与此同时，实验组的自评焦虑量表评分、自评抑郁量表评分以及肺部感染、关节僵硬和深静脉血栓等并发症的发生率均低于对照组(P < 0.05)。结论：延续护理对老年髋部骨折患者的生活质量及长期功能恢复具有显著改善作用；焦虑症状、抑郁情绪及并发症的显著减轻有助于提升患者对护理服务的满意度。

Abstract: Objective: To provide continuous care for elderly patients with intertrochanteric fractures undergoing surgical treatment and to investigate its impact on quality of life and long-term functional recovery. Methods: This prospective study enrolled 96 elderly patients with intertrochanteric fractures who underwent surgical treatment in our hospital’s orthopedics department. Using a random number table, the patients were divided into a control group and an experimental group (48 cases each). The control group received standard care and discharge instructions, while the experimental group received additional post-discharge continuous care in addition to standard care. The study compared hip joint function (Harris Hip Score), quality of life (MOS-36 score), exercise adherence, anxiety levels (Self-Rating Anxiety Scale score), depression severity (Self-Rating Depression Scale score), postoperative complications, and satisfaction with post-discharge care between the two groups. Results: Compared with the control group, the experimental group showed significant improvements in Harris Hip Score, physical function, overall health status, social functioning, role-emotional state, and mental health scores on the MOS-36 Brief Health Survey at 3 months and 12 months post-discharge (P < 0.05), as well as higher satisfaction with out-of-hospital care. Additionally, the experimental group exhibited lower self-rated anxiety scores, lower self-rated depression scores, and fewer occurrences of complications such as pulmonary infections, joint stiffness, and deep vein thrombosis compared to the control group (P < 0.05). Conclusion: Continuous care significantly improves the quality of life and long-term functional recovery in elderly patients with hip fractures; substantial reduction in anxiety symptoms, depressive mood, and complications contributes to enhanced patient satisfaction with nursing services.