一例骨科牵引床手术体位造成会阴III期压疮患者的护理

Nursing Care of a Patient with Perineal Stage III Pressure Sore Caused by Orthopaedic Traction Bed

摘要: 股骨转子间骨折(IFF)即股骨粗隆间骨折，是指股骨颈基底至小转子水平以上部位所发生的骨折，是老年人常见的损伤之一。IFF多见于老年患者，其身体耐受能力相对较差，因此创伤小，操作简便，且固定可靠的内固定方式越来越受到临床重视。因而股骨近端防旋髓内钉(PFNA)作为近年来治疗股骨粗隆间骨折的微创内固定方式，越来越得到广泛应用。股骨骨折因周围肌肉发达，手法不易整复，整复后也不易维持对位，应用牵引床可以很容易地在C型臂X线机下通过调整牵引床装置达到良好的复位，并且在术中操作时始终保持良好的复位效果，不会发生体位的改变。所以牵引床已广泛应用于IFF复位内固定手术。但在牵引床的使用中体位的摆放不像其他常用手术简单，由于体位的放置过程较复杂，且手术对体位的要求特殊，实际操作中极易发生相关的护理问题。

Abstract: Femoral intertrochanteric fracture (IFF), the intertrochanteric fracture, refers to the fracture of the femoral neck from the basal to the small trochanter level, which is one of the common injuries in the elderly. IFF is more common in elderly patients, and its physical tolerance is relatively poor, so the trauma is small, the operation is simple, and the fixed and reliable internal fixation is more and more clinical attention. Therefore, the proximal femoral nail (PFNA) has been widely used as a minimally invasive internal fixation for the treatment of intertrochanteric fractures in recent years. Due to the surrounding muscles, the femur fracture is not easy to repair, and it is not easy to maintain the alignment after the recovery. The traction bed can be easily adjusted by the adjustment of the traction bed device under the C-arm X-ray machine, and during the operation. Always maintain a good reset effect during operation, no position change will occur. Therefore, the traction bed has been widely used in IFF reduction and internal fixation surgery. However, the position of the traction bed is not as simple as other common operations. Because the placement process of the posture is complicated, and the requirements for the posture of the operation are special, the related nursing problems are easily caused in actual operation.