ERAS联合延伸护理在老年股骨颈骨折术后患者中的应用研究——以右江民族医学院附属医院为例

The Application of ERAS Combined Extension Nursing in Elderly Patients with Femoral Neck Fracture after Operation—Take the Affiliated Hospital of Youjiang Medical College for Nationalities as an Example

摘要: 目的：探讨ERAS联合延伸护理在全髋关节置换术治疗老年股骨颈骨折中的应用效果。方法：选取于2017年7月至2020年5月在右江民族医学院附属医院骨科进行全髋关节置换术的102例老年患者病例，依据建档病例采用随机数字对照研究，将患者分为对照组(50例)及观察组(52例)。其中：对照组采用常规护理模式进行护理；观察组应用ERAS联合延伸护理模式进行护理；比较对照组和观察组老年患者术后下床活动时间、拔除尿管时间、平均住院时间、护理效果满意度、围手术期并发症发生率、日常生活能力Bathel指数评分、Harris髋关节功能评分以及生活质量评分。结果：采用ERAS联合延伸护理的股骨颈骨折术后老年患者，下床活动时间、拔除尿管时间、平均住院时间缩短，差异有统计学意义(P < 0.05)；患者护理满意度从68.00%提高到94.23%，出院后生活质量显著提高；围手术期并发症发生率降低；Bathel指数评分从60.47 ± 2.25提高到93.73 ± 5.05，两组比较差异均有统计学意义(P < 0.05)，Harris髋关节功能评分从19.65 ± 3.40提高到29.35 ± 3.76，两组比较差异均有统计学意义(P < 0.05)；患者护理出院后生活质量评分，观察组评分均高于对照组，差异有统计学意义(P < 0.05)。结论：ERAS联合延伸护理模式应用于老年股骨颈骨折术后治疗中，明显缩短了下床活动时间、拔除尿管时间和平均住院时间，且显著提高患者满意率，降低了围手术期并发症发生率，同时提高了股骨颈骨折全髋关节置换术后老年患者的自理能力和术后生活质量，具有极高的临床推广应用价值。

Abstract: Objective: To explore the effect of ERAS combined extension nursing in the treatment of femoral neck fracture in elderly patients with total hip replacement. Methods: A total of 102 elderly patients who underwent total hip arthroplasty in the department of Orthopedics, Affiliated Hospital of Youjiang Medical College for Nationalities from July 2017 to May 2020 were selected. According to the documented cases, the patients were divided into control group (50 cases) and observation group (52 cases) by random number control study. Among them: The control group adopted the conventional nursing mode for nursing; the observation group applied ERAS combined extension nursing model for nursing; the postoperative ambulation time, catheter removal time, average length of hospital stay, nursing satisfaction, perioperative complication rate, Bathel index score, Harris hip function score and quality of life score were compared between the control group and the observation group. Results: For the elderly patients with femoral neck fracture treated by ERAS combined extension, the time of getting out of bed, the time of removing catheter and the average length of hospital stay were shortened, and the differences were statistically significant (P < 0.05); The satisfaction with patient care increased from 68.00% to 94.23%, and the quality of life after discharge significantly improved. The incidence of perioperative complications decreased. Bathel index score increased from 60.47 ± 2.25 to 93.73 ± 5.05, and the difference between the two groups was statistically significant (P < 0.05), Harris hip function score increased from 19.65 ± 3.40 to 29.35 ± 3.76, and the difference between the two groups was statistically significant (P < 0.05); The quality of life scores of patients after nursing and discharge were all higher in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusion: ERAS joint extends the model of nursing care in elderly femoral neck fracture in postoperative treatment, significantly shortened the bed activity time, root out the urine tube time and the average length of hospital stay, and significantly improve the patients’ satisfaction, reduced the incidence of perioperative complications, and improve the femoral neck fracture after total hip replacement of elderly patients with postoperative self-care ability and life quality, has a very high value of clinical application.