实用医学杂志 ›› 2021, Vol. 37 ›› Issue (3): 405-409.doi: 10.3969/j.issn.1006⁃5725.2021.03.026

• 临床护理 • 上一篇    下一篇

围术期快速康复护理模式对老年股骨颈骨折术后谵妄及康复质量的影响

蒋云雯, 胡皎 ,高慧秋 ,傅育红   

  1. 无锡市第九人民医院,无锡市骨科医院(江苏无锡 214062)
  • 出版日期:2021-02-10 发布日期:2021-02-10
  • 通讯作者: 傅育红 E⁃mai:1069561233@qq.com
  • 基金资助:
    江苏省第十四批“六大人才高峰”高层次人才培养项目(编号:WSW⁃102)

Effects of enhanced recovery after surgery(ERAS)on perioperative delirium and rehabilitation quality in aged patients with femoral neck fractures

JIANG Yunwen,HU Jiao,GAO Huiqiu,FU Yuhong   

  1. Wuxi Orthope⁃dics Hospital,Wuxi 214062,China
  • Online:2021-02-10 Published:2021-02-10
  • Contact: FU Yuhong E⁃mail:1069561233@qq.com

摘要:

目的 通过对老年股骨颈骨折手术病人围术期引入快速康复(EARS)护理模式,观察其对患者术后谵妄发生及康复质量的影响。方法 选取2017 7 月至 2019 6 月符合条件的 176 例老年股骨颈骨折患者为研究对象,按入院时间顺序分为传统护理组和快速康复组。在传统护理组基础上,快速康复组加入快速康复护理措施。观察两组患者术后 24、48、72 h 和总住院期间的谵妄发生情况和对应的睡眠质量,比较住院时间、首次下床时间和出院后随访的生活质量。结果 快速康复组术后48、72 h、总发生例数对比差异有统计学意义(P < 0.05),而术后 24 h 发生例数对比差异无统计学意义(P > 0.05)。两组患者术后睡眠质量对比差异有统计学意义(P < 0.05)。快速康复组首次下床时间、住院时间以及随访的 Harris 评分和 SF⁃36 量表评分均高于传统组,差异有统计学意义(P < 0.05)。结论 本研究通过对老年股骨颈骨 折患者引入快速康复护理模式,改善了患者术后的睡眠质量,降低谵妄发生,缩短平均住院时间,提高患 者生活质量。

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Abstract:

Objective To introduce the EARS nursing mode to the elderly patients with femoral neck frac⁃ ture surgery during the perioperative period and observe its effect on postoperative delirium and rehabilitation quality. Methods 176 elderly femoral neck fracture patients from July 2017 to June 2019 were selected as the research subjects. These patients were divided into traditional nursing group and ERAS group according to the time of admis⁃ sion. Preoperative general data of the two groups were not statistically significant(P > 0.05). This study observed and compared the incidence of delirium and sleep quality for 24,48,and 72 hours after surgery and the total hos⁃ pital stay,the length of hospital stay,the first landing time and the quality of life at 1,3,6,and 12 months after surgery. Results The incidence of delirium in the ERAS group was lower than that in the traditional nursing group except for 24 hours after operation,and the difference was statistically significant(P < 0.05). The difference in sleep quality between the two groups of patients after 24 h,48 h and 72 h was statistically significant(P < 0.05). The time to first landing and hospital stay in the ERAS group were also shorter than those in the traditional nursing group,and the differences were statistically significant(P < 0.05). The Harris score and SF⁃36 scale scores of patients in the ERAS group were higher than those in the traditional group at 1,3,6,12 months after operation (P < 0.05). Conclusions This research introduced a ERAS nursing mode to the elderly patients with femoral neck fractures to reduce the incidence of delirium and promote patients to resume their regular lives as soon as possible and shorten the average hospitalization time. This method can improve the quality of life for patients improve the quality of nursing,and provide ideas for geriatric nursing.

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