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| Application of “standard procedure of analgesic care” in postoperative care of disabled elderly patients after hip replacement under multidisciplinary joint model |
| ZHAGN Liwei1 YANG Yiqun1 LI Qun2 XIAO Yaolin1▲ |
1.Department Nursing, Chinese Medicine Gezhouba Central Hospital·the Third Clinical Medical College of Three Gorges University, Hubei Province, Yichang 443000, China;
2.Department Emergency Medicine, Chinese Medicine Gezhouba Central Hospital·the Third Clinical Medical College of Three Gorges University, Hubei Province, Yichang 443000, China |
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Abstract Objective To explore the application effect of “standard procedure of analgesic care” in the nursing of disabled elderly patients after hip replacement under the model of multidisciplinary association (MDT). Methods From January to December 2018, 40 disabled elderly patients who planned to undergo artificial hip replacement were selected from the Orthopedic Surgery Department of the Chinese Medicine Gezhouba Central Hospital·the Third Clinical Medical College of Three Gorges University (hereinafter referred to as “our hospital”). Random number table method was used to divide the patients into observation group and control group. 19 cases in control group were given postoperative analgesia routine nursing; 21 patients in the observation group adopted MDT model “standard procedure of analgesic care”. Short-term postoperative analgesia efficacy (pain intensity at 12 h, sleep duration at 72 h, time of first getting out of bed, and length of hospital stay), Harris hip score, Barthel index score, SF-36 quality of life score, postoperative complications and other indicators were compared between the two groups. Results There were significant differences in 12 h postoperative pain intensity, 72 h sleep time, first time out of bed, length of stay, Harris hip score, Barthel index score and SF-36 quality of life score at 1 and 3 months after discharge between the two groups (all P ＜ 0.05). There was no significant difference in the incidence of pulmonary infection, constipation, pressure sore, deep vein thrombosis and dislocation of prosthesis between the two groups (P ＞ 0.05). Conclusion MDT “analgesic nursing standard procedure” has definite analgesic effect on incapacitive elderly patients after hip replacement, and has the advantages of safety, reliability and feasibility.
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[1] 民政部.2015年社会服务发展统计公报[EB/OL].（2016-07-11）[2017-01-17]. http：//www.Mca.Gov.cn/article/sj/tijb/201607/20160700001136.shtml.
[2] 全国老龄委员会工作办公室.三部门发布第四次中国城乡老年人生活状况抽样调查成果[EB/OL].（2016-10-09）[2017-01-17]. http：//www.Cncaprc.Gov.cn/contents/2/177118.Htlm.
[3] 刘云东，冯雅楠，王玉环.失能老年人长期照护需求及影响因素[J].中国老年学，2016，36（6）：1482-1484.
[4] Archer KR，Devin CJ，Vanston SW，et al. Cognitivebehavioral-based physical therapy for patients with chronic-pain undergoing lumbar spine surgery a randomized controlled trial [J]. J Pain，2016，17（1）：76-89.
[5] Adnan R，Van Oosterwijck J，Cagnie B，et al. Determing predictive outcome factors for a multimodal treatment program in low back pain patients：a retrospective cohort study [J]. J Manipulative Physiol Ther，2017，40（9）：659-667.
[6] 宋莹莹，张岚，梁瑛琳，等.慢性下腰痛患者恐动症的研究进展[J].护理管理杂志，2018，18（8）：572-575.
[7] Trocoli TO，Botelho RV. Prevalence of anxiety，depression and kinesiophobia in Patients with low back pain and their association with the symptoms of low back spinal pain [J]. Rev Bras Reumatol Engl Ed，2016，56（4）：330-336.
[8] 方牡秀.疼痛控制护理对下肢骨折患者术后疼痛及功能锻炼的影响[J].医学理论与实践，2017，30（14）：2164-2165.
[9] Botti M，Kent B，Bucknall T，et al. D evelopment of a Management Algorithm for Post-operative Pain（MAPP）after total Knee and total hip replacement；study rationale and design [J]. Implement Sci，2014，9（110）：2593-2598.
[10] 王文慧，张利峰，李信欣，等.髋关节置换术后患者不同时期关节功能变化及其影响因素研究[J].中华护理杂志，2017，52（6）：649-653.
[11] 蒋煜青，黄健，梁传兴，等.全髋关节置换术结合快速康复外科理念治疗老年股骨颈骨折[J].中国实用医药，2017， 12（17）：17-19.
[12] 周雪梅，陈洁，唐永利.快速康复外科理念应用于全髋关节置换术围术期的效果分析[J].世界最新医学信息文摘：电子版，2017（18）：1-2.
[13] 杨静华，陈丽光，陈谊，等.中西医结合护理对人工髋关节置换术后疼痛的影响[J].当代护士：下旬刊，2017，21（5）：55-58.
[14] 杜世正，胡玲莉，柏亚妹，等.自我效能和恐惧-回避信念与应对方式对慢性腰背痛患者生命质量的影响路径[J].中国全科医学，2017，20（35）：4397-4403， 4411.
[15] 冯倩茜，金三丽.腰椎管狭窄症患者术后康复水平及康复行为的纵向研究[J].护理学杂志，2017，32（24）：85-87.
[16] 陈丽冰，刘玉琴，吴彩勤，等.快速康复外科理念在保留股骨颈型人工全髋关节置换术围手术期护理的研究[J].中国实用医药，2017，12（3）：165-167.
[17] Ponnusamy KE，Naseer Z，El Dafrawy MH，et al. Post-Discharge Care Duration，Charges，and Outcomes Among Medicare Patients After Primary Total Hip and Knee Arthroplasty [J]. J Bone Joint Surg Am，2017，99（11）：e55.
[18] 王菊香.持续性被动运动锻炼结合康复护理对老年髋骨骨折术后膝关节功能恢复的效果[J].临床护理杂志，2016，15（4）：43-45.
[19] 高健，沈志敏，王国胜，等.不同材料髋关节假体置换在老年股骨转子间骨折中的应用研究[J].中国现代医生，2018，56（17）：17-20.
[20] 吴彦.综合护理干预应用在全髋关节置换术的效果观察[J].中外医学研究，2017，15（34）：132-134.
[21] 曾叶玲.合理情绪化疗法对高龄髋关节置换术患者术后负性情绪及疼痛感的影响[J].临床护理杂志2017，16（2）：41-43.
[22] 曾秋芬，张雪美.人工全髋关节置换术后翻修术患者围手术期优质护理对预后影响观察[J].中外医学研究，2017，15（34）：109-110.
[23] 王龙虎，孙义，闫娟，等.重力肌群锻炼对胸腰椎骨折术后患者功能恢复的影响[J].护理学杂志，2018，33（4）：1-3.
[24] 贾健，成凯.不同手术入路全髋关节置换术对髋臼发育不良的疗效对比研究[J].中国医学创新，2019，16（23）：6-10.
[25] 郭丽萍，史晓丽，顾英，等.“医护一体化”模式在老年髋部骨折患者中的应用效果[J].中国医药导报，2017，14（35）：159-162. |
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