Department of Spine Surgery, Second Affiliated Hospital, Harbin Medical University, Baojian Road 146, Harbin, 150086, China.
Department of Blood Sampling Room, First Affiliated Hospital, Harbin Medical University, Youzheng Road 23, Harbin, 150001, China.
Eur Geriatr Med. 2020 Aug;11(4):519-525. doi: 10.1007/s41999-020-00298-y. Epub 2020 Mar 3.
The nursing concept has changed from being "disease centered" to "patient centered". The aim of this study was to explore the clinical effects of a fast track surgery nursing program in the perioperative care of older patients with a hip fracture.
Total of 84 patients with hip fracture who were hospitalized in our department were randomly divided into the conventional group (42 cases) and fast track surgery group (42 cases) to compare the psychological state, pain degree, serum inflammatory factors, coagulation, hip function, and incidence of deep venous thrombosis of lower extremities between the groups before and after the nursing program.
There were no significant differences between groups as measured by a self-rating anxiety scale, self-rating depression scale, visual analogue score, IL-6, IL-10, TNF-α, coagulation factor level, or Harris score between groups before nursing (P > 0.05). The self-rating anxiety scale, self-rating depression scale, visual analogue score, IL-6, IL-10, TNF-a, coagulation factor level, and deep venous thrombosis in fast track surgery group after nursing were significantly lower than in the conventional group, and the Harris score was significantly higher (P < 0.05).
The fast track surgery nursing program can effectively alleviate adverse emotions and pain of patients with a hip fracture, reduce inflammation, improve coagulation and hip function after operation, and reduce the incidence of deep venous thrombosis after operation.
护理理念已从“以疾病为中心”转变为“以患者为中心”。本研究旨在探讨快速康复外科护理方案在老年髋部骨折患者围手术期护理中的临床效果。
将我院骨科收治的 84 例髋部骨折患者随机分为常规组（42 例）和快速康复外科组（42 例），比较两组护理前后的心理状态、疼痛程度、血清炎症因子、凝血功能、髋关节功能及下肢深静脉血栓形成发生率。
护理前两组患者的焦虑自评量表、抑郁自评量表、视觉模拟评分、IL-6、IL-10、TNF-α、凝血因子水平、Harris 评分比较，差异均无统计学意义（P>0.05）；护理后快速康复外科组的焦虑自评量表、抑郁自评量表、视觉模拟评分、IL-6、IL-10、TNF-α、凝血因子水平均明显低于常规组，Harris 评分明显高于常规组（P<0.05）。
快速康复外科护理方案可有效缓解髋部骨折患者的不良情绪和疼痛，减轻炎症反应，改善术后凝血和髋关节功能，降低术后下肢深静脉血栓形成的发生率。
