快速康復理念在老年人工髖關節置換術患者圍手術期護理中的臨床研究

易錢貞　杜玲玲

[摘要] 目的 探討快速康復理念在老年人工髖關節置換術患者圍手術期護理中的效果。 方法 將2017年6月～2018年4月我院接診的39例患者納入本研究。按照干預方法不同將患者為觀察組21例和對照組18例。觀察組：快速康復理念。對照組：傳統模式。比較兩組手術時間和住院時間、疼痛情況、髖關節功能評分、并發癥發生情況。 結果 觀察組平均手術時間、平均住院時間均低于對照組（P<0.05）；觀察組干預后疼痛評分低于干預前和對照組（P<0.05）；觀察組干預后髖關節功能評分高于干預前和對照組（P<0.05）；觀察組并發癥發生率低于對照組（P<0.05）。 結論 快速康復理念能夠改善老年患者人工髖關節置換術圍手術期護理效果，患者手術時間短，住院時間少，疼痛輕，髖關節功能改善較好，而且并發癥明顯減少，應用價值較高。

[關鍵詞] 快速康復理念；人工髖關節置換術；圍手術期；髖關節功能；并發癥

[中圖分類號] R473.6 [文獻標識碼] B [文章編號] 1673-9701（2018）26-0151-04

Clinical study on rapid rehabilitation concept in the perioperative nursing of artificial hip joint replacement in elderly patients

YI Qianzhen DU Lingling

Second Department of Orthopaedics， Yichun People's Hospital in Jiangxi Province， Yichun 336000， China

[Abstract] Objective To explore the clinical effect of rapid rehabilitation concept in perioperative nursing of artificial hip joint replacement in elderly patients. Methods A total of 39 patients admitted in our hospital from June 2017 to April 2018 were enrolled in the study. According to the different intervention methods， the patients were divided into the observation group（n=21） and the control group（n=18）. The observation group was treated with the concept of rapid recovery. The control group was given traditional mode. The operation time and hospitalization time， pain， hip function score and complications were compared between the two groups. Results The average operation time and average hospitalization time of the observation group were lower than those of the control group（P<0.05）. The pain score of the observation group after intervention was lower than that before intervention and that of the control group（P<0.05）. The hip function score of the observation group after the intervention was higher than that before the intervention and that of the control group （P<0.05）. The incidence of complications in the observation group was lower than that in the control group（P<0.05）. Conclusion The rapid rehabilitation concept can improve the perioperative nursing effect of artificial hip joint replacement in elderly patients. The patients have short operation time， less hospital stay， less pain， better hip function improvement， and significantly reduced complications. It has high application value.

[Key words] Rapid rehabilitation concept； Artificial hip joint replacement； Perioperative period； Hip function； Complications

快速康復外科理念（fast track surgery，FTS）是指在術前、術中及術后應用各種已證實有效的方法（強化心理疏導、術前術后配合指導、飲食管理、疼痛管理、個體化功能鍛煉指導等）以減少手術應激及并發癥，加速患者術后的康復[1-2]。隨著我國人口老齡化進程的加快，人工髖關節置換術在老年患者人群中的應用越來越廣泛，在老年人工髖關節置換術患者圍手術期中引入快速康復外科理念，能有效降低患者術后早期并發癥的發生，減輕關節疼痛，加快患者康復進程，縮短住院時間，節省醫療費用，提高患者滿意度和就醫體念[4-6]，現報道如下。

1 資料與方法

1.1 一般資料

將2017年6月～2018年4月我院接診的39例患者納入本研究。患者均行單側髖關節置換術。其中男18例，女21例；年齡66～89歲，平均（78.25±4.35）歲；其中，股骨頭缺血壞死2例，髖關節骨性關節炎4例，股骨粗隆間骨折9例，股骨頸骨折24例。按照干預方法不同將患者為觀察組21例與對照組18例。……