持续性护理对老年股骨粗隆间骨折术后患者的效果

doi:10.3969/j.issn.1006-9771.2022.02.006

Abstract

Abstract:

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.

Key words: continuous nursing, aged, femoral intertrochanteric fracture, limb function, nursing quality

CLC Number:

R687.3

ZHAO Kecong,ZHANG Baocui,FAN Jingyu,YANG Wei,WANG Xuehua,YUE Xiaoxin,CAO Yanyuan,CHEN Ruikun,LIU Siyu,MIN Hongwei. Effect of continuous nursing intervention on nursing quality and postoperative function in elderly patients after femoral intertrochanteric fracture[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 170-174.

Figures/Tables 4

References 27

[1]	FLIKWEERT E R, WENDT K W, DIERCKS R L, et al. Complications after hip fracture surgery: are they preventable?[J]. Eur J Trauma Emerg Surg, 2018, 44(4): 573-580. doi: 10.1007/s00068-017-0826-2
[2]	季斌, 刘师良, 杨东方, 等. 老年骨质疏松粗隆间骨折的快速康复外科治疗[J]. 中国矫形外科杂志, 2019, 27(20): 1845-1849.
	JI B, LIU S L, YANG D F, et al. Enhanced recovery after surgery program for osteoporotic femoral intertrochanteric fracture in elderly[J]. Orthop J Chin, 2019, 27(20): 1845-1849.
[3]	韩晓军, 张文治, 陈祥云, 等. 股骨粗隆间骨折临床治疗的研究进展[J]. 现代中西医结合杂志, 2019, 28(34): 3866-3872.
	HAN X J, ZHANG W Z, CHEN X Y, et al. Research progress in clinical treatment of femoral intertrochanteric fracture[J]. Mod J Integr Tradit Chin West Med, 2019, 28(34): 3866-3872.
[4]	CHANG S M, HOU Z Y, HU S J, et al. Intertrochanteric femur fracture treatment in Asia: what we know and what the world can learn[J]. Orthop Clin North Am, 2020, 51(2): 189-205. doi: 10.1016/j.ocl.2019.11.011
[5]	王生余. 老年股骨粗隆间骨折治疗的临床进展综述[J]. 中国老年学杂志, 2016, 16(57): 38-39.
	WANG S Y. Review of clinical progress in the treatment of femoral intertrochanteric fracture in the elderly[J]. Chin J Gerontol (Electronic Version), 2016, 16(57): 38-39.
[6]	刘昊楠, 贺良, 张贵林, 等. 髋部骨折住院患者治疗情况的初步分析[J]. 实用医学杂志, 2015, 31(24): 4087-4089.
	LIU H N, HE L, ZHANG G L, et al. Preliminary analysis of treatment of hospitalized patients with hip fracture[J]. J Pract Med, 2015, 31(24): 4087-4089.
[7]	邢秀峰. 两种手术方案治疗股骨粗隆间骨折的临床疗效比较[J]. 医药论坛杂志, 2018, 39(11): 98-100.
	XING X F. Clinical Comparison of two surgical techniques in the treatment of femoral intertrochanteric fracture[J]. J Med Forum, 2018, 39(11): 98-100.
[8]	赵福龙, 王雪飞, 张亚奎, 等. 老年股骨粗隆间骨折患者围手术期死亡危险因素分析[J]. 中国骨与关节损伤杂志, 2020, 35(4): 383-385.
	ZHAO F L, WANG X F, ZHANG Y K, et al. Analysis of risk factors for perioperative mortality in elderly patients with femoral intertrochanteric fracture[J]. Chin J Bone Joint Inj, 2020, 35(4): 383-385.
[9]	常立阳, 冯志仙, 邵荣雅, 等. 住院患者护理满意度测评量表的构建[J]. 中华护理杂志, 2012, 47(5): 454-456.
	CHANG L Y, FEGN Z X, SHAO R Y, et al. Development of the inventory of inpatient satisfaction with nursing[J]. Chin J Nurs, 2012, 47(5): 454-456.
[10]	HARRIS W H. The first 50 years of total hip arthroplasty: lessons learned[J]. Clin Orthop Relat Res, 2009, 467(1): 28-31. doi: 10.1007/s11999-008-0467-1
[11]	王人楷, 章浩, 李迪, 等. 股骨粗隆间骨折临床分型研究进展[J]. 中国矫形外科杂志, 2018, 26(20): 1882-1887.
	WANG R K, ZHANG H, LI D, et al. Advance in clinical classification of femur intertrochanteric fractures[J]. Orthop J Chin, 2018, 26(20): 1882-1887.
[12]	田开峰, 刘凡凡. 护理干预在老年股骨粗隆间骨折抗旋股骨近端髓内针内固定术后患肢康复中的应用[J]. 护士进修杂志, 2015, 30(23): 2174-2175.
	TIAN K F, LIU F F. J Nurs Further Educ, 2015, 30(23): 2174-2175.
[13]	贺红梅, 安帅, 张新玉, 等. 老年股骨粗隆间骨折术后早期强化功能锻炼的对比研究[J]. 北京医学, 2017, 39(2): 150-153.
	HE H M, AN S, ZHANG X Y, et al. Comparative study on the effectiveness of early intensive home-based rehabilitation program and routine treatment in elderly intertrochanteric fracture[J]. Beijing Med, 2017, 39(2): 150-153.
[14]	田桂香, 巫远华. 高龄股骨粗隆间骨折患者使用优质护理的效果观察[J]. 医学理论与实践, 2018, 31(24): 3771-3773.
	TIAN G X, WU Y H. Effect observation of high quality nursing on elderly patients with femoral intertrochanteric fracture[J]. J Med Theor Prac, 2018, 31(24): 3771-3773.
[15]	SOCCI A R, CASEMYR N E, LESLIE M P, et al. Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations[J]. Bone Joint J, 2017, 99(1): 128-133.
[16]	张晓华, 袁丽, 鲁丽杰. 连续护理模式对老年髋部骨折术后患者的综合干预效果分析[J]. 中国卫生标准管理, 2017, 8(21): 179-181.
	ZHANG X H, YUAN L, LU L J. Effect of continuous nursing mode on comprehensive intervention in elderly patients with hip fracture[J]. Chin Health Standard Manage, 2017, 8(21): 179-181.
[17]	傅静, 张孟喜, 刘跃华, 等. 老年综合评估护理计划在高龄老年住院病人中的应用[J]. 全科护理, 2016, 14(23): 2401-2403.
	FU J, ZHANG M X, LIU Y H, et al. Application of elderly comprehensive evaluation nursing plan in elderly inpatients[J]. Chin Genenral Pract Nurs, 2016, 14(23): 2401-2403.
[18]	李艳利. 中西医结合干预对老年股骨粗隆间骨折患者康复的影响[J]. 长春中医药大学学报, 2016, 32(4): 789-791.
	LI Y L. Effect of combined-Chinese and Western medicine intervention on rehabilitation in elder patients with femoral intertrochanteric fracture[J]. J Changchun Univ Chin Med, 2016, 32(4): 789-791.
[19]	宁荣. 股骨粗隆间骨折术后康复功能锻炼及护理常规的临床研究[J]. 中国医药科学, 2016, 6(10): 112-115.
	NING R. Clinical study of postoperative functional rehabilitation exercises and nursing routine of intertrochanteric fracture[J]. Chin Med Pharm, 2016, 6(10): 112-115.
[20]	刘会平. 老年股骨粗隆间骨折患者PFNA 内固定的早期积极康复护理[J]. 医疗装备, 2016, 29(3): 175-176.
	LIU H P. Early active rehabilitation nursing in elderly patients with femoral intertrochanteric fracture treated with PFNA internal fixation[J]. Med Equip, 2016, 29(3): 175-176.
[21]	霍瑞君. 康复护理模式对预防老年股骨粗隆间骨折患者下肢深静脉血栓效果观察[J]. 泰山医学院学报, 2017, 38(9): 1075-1076.
	HUO R J. Effect observation of rehabilitation nursing model on preventing lower extremity deep venous thrombosis in elderly patients with femoral intertrochanteric fracture[J]. J Taishan Med Coll, 2017, 38(9): 1075-1076.
[22]	殷梅平. 综合护理干预在全髋关节置换术后老年病人中的应用[J]. 护理研究, 2017, 31(23): 2931-2933.
	YIN M P. Application of comprehensive nursing intervention for elderly patients after total hip replacement[J]. Chin Nurs Res, 2017, 31(23): 2931-2933.
[23]	COLEMAN E A, BOULT C. Improving the quality of transitional care for persons with complex care needs[J]. J Am Geriatr Soc, 2003, 51(4): 556-557. doi: 10.1046/j.1532-5415.2003.51186.x
[24]	杨梅, 邓晓峰, 刘敏, 等. 老年髋部骨折患者实施康复护理的意义研究[J]. 心理医生, 2016, 22(2): 150-151.
	YANG M, DENG X F, LIU M, et al. Study on the significance of rehabilitation nursing in elderly patients with hip fracture[J]. Psychologist, 2016, 22(2): 150-151.
[25]	司世雷. 髋骨骨折老年人232 例康复训练干预效果研究[J]. 实用医技杂志, 2017, 24(4): 434-436.
	SI S L. Effect of rehabilitation training on 232 elderly patients with hip fracture[J]. J Pract Med Tech, 2017, 24(4): 434-436.
[26]	蒋莉, 张新春, 魏海楠. 延续性护理对高龄髋部骨折患者术后髋关节功能、生活质量及负面情绪的影响[J]. 国际护理学杂志, 2018, 37(9): 1178-1182.
	JIANG L, ZHANG X C, WEI H N. The influence of continuous nursing on hip joint function, quality of life and negative emotion in patients with advanced hip fracture[J]. Int J Nurs, 2018, 37(9): 1178-1182.
[27]	HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial[J]. Lancet, 2020, 395(10225): 698-708. doi: 10.1016/S0140-6736(20)30058-1

项目		对照组 (n = 50)	观察组(n = 50)	t/χ²值	P值
性别/n	男性	33	34	0.045	0.832
性别/n	女性	17	16	0.045	0.832
年龄/岁		74.95±1.92	74.99±1.95	0.103	0.918
Evans分型/n	Ⅰ型	16	12	0.983	0.612
	Ⅱ型	24	25
	Ⅲ型	10	13
受伤原因/n	车祸伤	15	12	0.457	0.499
受伤原因/n	摔伤	35	38	0.457	0.499

组别	n	干预前	干预后	t值	P值
对照组	50	39.35±2.54	65.71±3.16	45.98	< 0.001
观察组	50	40.22±2.55	75.66±3.45	58.41	< 0.001
t值		1.709	15.03
P值		0.091	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	50	6.37±1.27	3.21±0.51	16.33	< 0.001
观察组	50	6.41±1.32	2.35±0.36	20.98	< 0.001
t值		0.154	9.749
P值		0.878	< 0.001

Effect of continuous nursing intervention on nursing quality and postoperative function in elderly patients after femoral intertrochanteric fracture

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 27

Related Articles 15

Metrics

Comments

Recommended 0

[1]	QI Li, ZHANG Lei, QI Yi, FENG Lijun, LIU Dongmei, MA Huina. Effect of cardiopulmonary rehabilitation exercise on old patients with chronic obstructive pulmonary disease and chronic heart failure [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 191-197.
[2]	ZHANG Jihui, YI Longyue, YANG Yuanbin. Associated factors of balance dysfunction and its correlation with functional lower limb muscle strength in middle-aged and older adults: an analysis based on CHARLS database [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 13-22.
[3]	LIN Lixia, ZENG Qiuchan, GUO Yunyuan, LIANG Rongxiang, WU Hao, SHAO Yuping. Relationship between patterns of sleep duration and activities of daily living among middle-aged and older adults [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 331-338.
[4]	ZHAO Wen, WANG Can, LI Liwen. Effect of comprehensive respiratory training using action research method on old patients with chronic obstructive pulmonary disease [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(12): 1464-1471.
[5]	QIN Qing, LIU Ye, YE Haiyan, LI Chen, CHEN Di. Robot-assisted therapy for upper limb of stoke: a bibliometrics analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(1): 85-98.
[6]	ZHU Bowen, ZHAO Suhong, LI Miaoxiu, ZHANG Shuaipan, YAO Chongjie, ZHU Qingguang, FANG Min. Effect of manual therapy based on surface electromyography on knee osteoarthritis for older people: a randomized controlled trial [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1099-1106.
[7]	DAN Yuqin, SU Jianing, DING Yi, WANG Xueyan, XU Danghan, WANG Jinghua, WU Yujing, ZHANG Mengyuan, YIN Meng, LU Haifeng, YU Gongchang, LI Li. Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 861-868.
[8]	SU Zhaoyin, KANG Weihan, LIU Yatao, LÜ Yuan, Michael NERLICH. Relationship between physical activity levels and stroke risk among middle-aged and older adults in China based on CHARLS data [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 449-453.
[9]	LIU Xing, ZHOU Yumei, XU Huili, PENG Jianying, XIE Zheshu, XING Limin, ZHAO Jun. Structural equation model of influencing factors of anticipatory grief among main caregivers of young and middle-aged patients with severe stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 454-461.
[10]	WU Jiayu, MENG Detao, LIANG Xiaoxiao. Effect of physical activity levels on risk of Parkinson's disease: a cross-sectional analysis based on China Health and Retirement Longitudinal Study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1135-1139.
[11]	SUN Fengbao, ZHANG Xiaofeng, LIU Yong, XU Zhitao, JIN Zhenhua. Effect of multimodal mirror therapy on upper limb and hand function for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 77-81.
[12]	LIU Peng,SU Chun,SHAO Lei,JIA Mengyi,WANG Haixia,TIAN Siyuan,GENG Kaiqing,ZHANG Yanan. Effect of modified constraint-induced movement therapy based on Chinese version of Quality of Upper Extremity Skills Test on upper limb function for children with hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 897-902.
[13]	LIANG Ting,CAO Daigui,SUN Shunxia,DING Yongqing,WU Cai'e,ZHANG Shengli,YANG Fubin,SHEN Kai. Effects of internet plus continuous rehabilitation nursing on older patients after lumbar fusion [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(7): 863-868.
[14]	XU Jinyan,ZHANG Qianqian,ZHANG Ying. Factors influencing satisfaction of rehabilitation services quality for older people purchased by government [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 730-738.
[15]	XUAN Wenru,SHEN Yuqing,ZHOU Miao,FENG Shiwen. Bilingual training for cognition of older adults: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 578-584.

组别	n	显效	有效	无效
对照组	50	13	28	9
观察组	50	21	27	2