摘要
目的研究基于循证依据的风险护理在胫腓骨骨折切开复位内固定术后护理中的应用效果。方法选取2022年2月至2023年12月河南省中医院收治的92例胫腓骨骨折患者作为研究对象,按随机数表法分为研究组和对照组各46例,对照组患者采用常规护理干预,研究组患者采用基于循证依据的风险护理干预。两组患者均护理至出院,出院后随访6个月。护理前及随访6个月时,比较两组患者的膝关节评分、膝关节活动度;护理结束出院前,比较两组患者的牵引时间、骨折恢复时间;护理结束出院前,比较两组患者的日常生活能力(步行活动、可控大小便、穿衣、修饰、洗浴、进食);护理前及护理结束出院前,比较两组患者的自我护理能力(健康认知、自护技能、自护责任感、自我概念);出院前,比较两组患者在护理期间的并发症发生率。结果护理前,两组患者的膝关节评分、膝关节活动度比较差异无统计学意义(P>0.05);随访6个月时,两组患者的膝关节评分、膝关节活动度均较护理前上升,且研究组患者的膝关节评分、膝关节活动度分别为(86.01±6.15)分、(89.18±13.02)°,明显高于对照组的(82.06±5.71)分、(75.28±12.79)°,差异均有统计学意义(P<0.05)。出院前,研究组患者的牵引时间、骨折恢复时间分别为(35.02±2.58)d、(99.20±7.86)d,明显短于对照组的(47.80±3.65)d、(129.03±10.65)d,差异有统计学意义(P<0.05)。出院前,研究组患者的步行活动、可控大小便、穿衣、修饰、洗浴、进食评分分别为(92.01±2.75)分、(91.89±1.08)分、(92.67±2.38)分、(92.50±1.73)分、(92.80±1.09)分、(92.79±1.15)分,明显高于对照组的(81.89±2.69)分、(82.01±1.12)分、(82.03±1.23)分、(83.72±1.50)分、(80.28±1.47)分、(80.69±1.13)分,差异均有统计学意义(P<0.05)。护理前,两组患者的健康认知、自护技能、自护责任感、自我概念评分比较差异均无统计学意义(P>0.05);护理结束出院前,两组患者的健康认知、自护技能、自护责任感、自我概念评分均较护理前上升,且研究组患者的健康认知、自护技能、自护责任感、自我概念评分分别为(97.06±2.28)分、(86.28±2.09)分、(97.02±2.60)分、(86.32±2.30)分,明显高于对照组的(90.21±1.98)分、(78.57±1.82)分、(85.90±2.10)分、(78.35±1.83)分,差异均有统计学意义(P<0.05)。研究组患者在护理期间的并发症总发生率为6.52%,明显低于对照组21.74%,差异有统计学意义(P<0.05)。结论基于循证依据的风险护理在胫腓骨骨折切开复位内固定术后护理中的应用效果显著,能够改善患者膝关节功能,降低并发症,能够提高患者的自我效能,改善日常生活能力。
Objective To investigate the efficacy of evidence-based risk nursing in postoperative care for tibio-fibular fractures after open reduction and internal fixation(ORIF).Methods A total of 92 patients with tibiofibular frac-tures admitted to Henan Provincial Hospital of Traditional Chinese Medicine from February 2022 to December 2023 were selected and randomly divided into a study group and a control group(46 cases each).Patients in the control group received routine nursing care,while those in the study group received evidence-based risk nursing.Both groups of pa-tients were cared for until discharge and followed up for 6 months.Knee joint scores and range of motion(ROM)were compared between the two groups before nursing and at 6-month follow-up.Traction time and fracture recovery time were compared before discharge.Daily living abilities(walking,continence,dressing,grooming,bathing,eating)were assessed before discharge.Self-care competencies(health knowledge,self-care skills,self-care responsibility,self-con-cept)were evaluated before nursing and before discharge.Complication rates during nursing were compared before dis-charge.Results Before nursing,there were no significant differences in knee joint scores or ROM between the two groups(P>0.05).At 6-month follow-up,both groups showed increased knee joint scores and ROM,with the study group achieving significantly higher scores than the control group(P<0.05):(86.01±6.15)points vs(82.06±5.71)points,(89.18±13.02)°vs(75.28±12.79)°,P<0.05.The study group had shorter traction time and fracture recovery time compared to the control group(P<0.05):(35.02±2.58)d vs(47.80±3.65)d,(99.20±7.86)d vs(129.03±10.65)d.Daily living ability scores(walking,continence,dressing,grooming,bathing,and eating)in the study group were(92.01±2.75)points,(91.89±1.08)points,(92.67±2.38)points,(92.50±1.73)points,(92.80±1.09)points,and(92.79±1.15)points,significantly higher than(81.89±2.69)points,(82.01±1.12)points,(82.03±1.23)points,(83.72±1.50)points,(80.28±1.47)points,and(80.69±1.13)points in the control group(P<0.05).Self-care competency scores(health knowledge,self-care skills,self-care re-sponsibility,and self-concept)improved after intervention in both groups;the scores in the study group were(97.06±2.28)points,(86.28±2.09)points,(97.02±2.60)points,(86.32±2.30)points,significantly higher than(90.21±1.98)points,(78.57±1.82)points,(85.90±2.10)points,(78.35±1.83)points in the control group(P<0.05).The study group had a signifi-cantly lower total complication rate(6.52%)than the control group(21.74%),P<0.05.Conclusion The application of evidence-based risk nursing in the postoperative care of open reduction and internal fixation of tibial and fibular frac-tures has significant effects,which can improve patients'knee joint function,reduce complications,improve patients'self-efficacy and improve their daily life ability.
作者
徐娜
张伟娜
杨靖华
徐敏
栾艳华
XU Na;ZHANG Wei-na;YANG Jing-hua;XU Min;LUAN Yan-hua(Department of Orthopedics and Traumatology,Henan Provincial Hospital of Traditional Chinese Medicine(Second Affiliated Hospital of Henan University of Traditional Chinese Medicine),Zhengzhou 450000,Henan,CHINA;Department of Obstetrics and Gynecology,Zhengzhou Shengma Maternity and Gynecology Hospital,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
2025年第13期1951-1955,共5页
Hainan Medical Journal
基金
2022年度河南省中医药科学研究项目(编号:2022ZYDZ1128)。
关键词
胫腓骨骨折
切开复位内固定术
循证依据
风险护理
膝关节功能
Tibiofibular fracture
Open reduction and internal fixation surgery
Evidence-based evidence
Risk management
Knee joint function
