结构式护理法对高龄椎体骨折行PVP患者治疗依从性和术后并发症的影响
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摘要
目的分析结构式护理法对高龄椎体骨折行经皮椎体成形术(PVP)患者治疗依从性和术后并发症发生的影响。方法 86例接受PVP治疗的高龄椎体骨折患者,按照随机数字表法,将患者随机分为研究组和对照组,每组43例。研究组采用结构式护理法,对照组采用常规护理。比较2组患者的治疗依从性、护理满意度及并发症的发生情况。结果与对照组比较,研究组在心理疏导、用药指导、饮食指导、疼痛干预、安全护理、运动及康复训练、并发症干预方面治疗依从性评分及总分均明显升高(P<0.05)。与对照组比较,研究组对护理服务合理性、全面性、及时性及连续性的满意度评分和总分均明显升高(P<0.01)。研究组发热、骨水泥外渗、再发骨折及肺栓塞等并发症发生率较对照组明显下降(P<0.05)。结论结构式护理法可显著提高行PVP术的高龄椎体骨折患者的治疗依从性及护理满意度,降低并发症的发生率,临床上宜提倡。
Objective To investigate the effects of structural nursing method on compliance of patients and postoperative complications in elderly patients with vertebral fracture after PVP percutaneous vertebroplasty(PVP).Methods A total of 86 elderly patients with vertebral fracture who were treated by PVP in our hospital from January 2016 to June 2018 were enrolled in the study.According to the random number table method,these patients were randomly divided into research group(n=43) and control group(n=43). The patients in research group were treated by structural nursing,however,the patients in control group were treated by routine nursing.The treatment compliance,nursing satisfaction degree and incidence of complications were observed and compared between the two groups.Results As compared with those in control group,the treatment compliance scores and total scores in the aspects of psychological counseling,medication guidance,diet guidance,pain intervention,safety nursing,exercise and rehabilitation training,complication intervention in research group were significantly increased(P<0.05).As compared with those in control group,the satisfaction scores and the total scores in the aspects of nursing service rationality, comprehensiveness, timeliness and continuity in research group were significantly decreased(P<0.05).Moreover the incidence rate of fever,cement exosmosis,recurrent fracture and pulmonary embolism in research group(6.98%) was significantly lower than that(25.58%) in control group(P<0.05).Conclusion The structural nursing method can significantly improve the treatment compliance and nursing satisfaction degree in elderly patients with vertebral fracture undergoing PVP,and can reduce the incidence of complications,therefor, which should be advocated in clinical practice.
Objective To investigate the effects of structural nursing method on compliance of patients and postoperative complications in elderly patients with vertebral fracture after PVP percutaneous vertebroplasty(PVP).Methods A total of 86 elderly patients with vertebral fracture who were treated by PVP in our hospital from January 2016 to June 2018 were enrolled in the study.According to the random number table method,these patients were randomly divided into research group(n=43) and control group(n=43). The patients in research group were treated by structural nursing,however,the patients in control group were treated by routine nursing.The treatment compliance,nursing satisfaction degree and incidence of complications were observed and compared between the two groups.Results As compared with those in control group,the treatment compliance scores and total scores in the aspects of psychological counseling,medication guidance,diet guidance,pain intervention,safety nursing,exercise and rehabilitation training,complication intervention in research group were significantly increased(P<0.05).As compared with those in control group,the satisfaction scores and the total scores in the aspects of nursing service rationality, comprehensiveness, timeliness and continuity in research group were significantly decreased(P<0.05).Moreover the incidence rate of fever,cement exosmosis,recurrent fracture and pulmonary embolism in research group(6.98%) was significantly lower than that(25.58%) in control group(P<0.05).Conclusion The structural nursing method can significantly improve the treatment compliance and nursing satisfaction degree in elderly patients with vertebral fracture undergoing PVP,and can reduce the incidence of complications,therefor, which should be advocated in clinical practice.
引文
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2 王林锋,陈小杰,陆成武,等.不同穿刺方向的椎体成形术治疗老年骨质疏松椎体压缩性骨折的疗效对比.中国老年学杂志,2017,37:4038-4039.
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4 黄震,王开明,廖亮,等.经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效及并发症对比分析.陕西医学杂志,2018,47:491-493.
5 梁军伟.经皮椎体成形术治疗骨质疏松性椎体骨折的临床体会.河北医药,2013,35:2164-2165.
6 尹利,李金红,陈媛,等.结构式心理护理在精神科急诊留观患者中的应用.国际护理学杂志,2016,35:814-817.
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8 Stevenson M,Gomersall T,Lloyd Jones M,et al.Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures:a systematic review and cost-effectiveness analysis.Health Technol Assess,2014,18:1-290.
9 Zhang L,Wang Q,Wang L,et al.Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures.Clin Interv Aging,2017,12:431-436.
10 Svensson HK,Olsson LE,Hansson T,et al.The effects of person-centered or other supportive interventions in older women with osteoporotic vertebral compression fractures-a systematic review of the literature.Osteoporos Int,2017,28:2521-2540.
11 Kucukler FK,Simsek Y,Turk A,et al.Osteoporosis and silent vertebral fractures in nursing home resident elderly men in Turkey.J Clin Densitom,2017,20:188-195.
12 付秋霞.舒适护理在椎体骨折护理中的应用.昆明医科大学学报,2013,34:173-175.
13 周雪梅.椎弓根钉固定结合伤椎体植骨成形治疗胸腰段椎体骨折的护理体会.实用临床医药杂志,2014,18:64-66.
14 丁莉.经皮骨水泥球珠堆积椎体成形术治疗椎体骨折的围手术期护理.国际护理学杂志,2013,32:2034-2035.
15 郭迎秋,郭少彤.椎体后凸成形术治疗周壁破损的骨质疏松性椎体压缩骨折的护理.中国实用护理杂志,2017,33:24-25.
16 李丽娜.胸腰椎体骨折患者围术期"三性"护理信息支持应用效果观察.东南国防医药,2018,20:90-92.
17 杨静.康复护理在胸腰段椎体骨折术后伴神经损伤患者中的应用.齐鲁护理杂志,2016,22:92-93.
18 姜艳,姚萍.图谱法康复训练对单纯性胸腰椎体骨折患者康复效果的影响.护理实践与研究,2015,12:146-147.
19 郭兰,管琳君.经皮椎体成形术治疗老年骨质疏松椎体压缩性骨折的护理.西部中医药,2016,29:127-128.
20 吴泳锐,陈秀芹.老年骨质疏松性椎体压缩性骨折经皮椎体成形术围手术期护理.中华全科医学,2015,13:310-312.
2 王林锋,陈小杰,陆成武,等.不同穿刺方向的椎体成形术治疗老年骨质疏松椎体压缩性骨折的疗效对比.中国老年学杂志,2017,37:4038-4039.
3 王应忠,张洋,严琪,等.经皮椎体成形术对老年骨质疏松椎体压缩性骨折患者疼痛程度、关节功能的影响.中国老年学杂志,2016,36:668-670.
4 黄震,王开明,廖亮,等.经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效及并发症对比分析.陕西医学杂志,2018,47:491-493.
5 梁军伟.经皮椎体成形术治疗骨质疏松性椎体骨折的临床体会.河北医药,2013,35:2164-2165.
6 尹利,李金红,陈媛,等.结构式心理护理在精神科急诊留观患者中的应用.国际护理学杂志,2016,35:814-817.
7 Turk AC,Sahin F,Kucukler FK,et al.Analysis of kyphosis,vertebral fracture and bone mineral density measurement in women living in nursing homes.Saudi Med J,2018,39:711-718.
8 Stevenson M,Gomersall T,Lloyd Jones M,et al.Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures:a systematic review and cost-effectiveness analysis.Health Technol Assess,2014,18:1-290.
9 Zhang L,Wang Q,Wang L,et al.Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures.Clin Interv Aging,2017,12:431-436.
10 Svensson HK,Olsson LE,Hansson T,et al.The effects of person-centered or other supportive interventions in older women with osteoporotic vertebral compression fractures-a systematic review of the literature.Osteoporos Int,2017,28:2521-2540.
11 Kucukler FK,Simsek Y,Turk A,et al.Osteoporosis and silent vertebral fractures in nursing home resident elderly men in Turkey.J Clin Densitom,2017,20:188-195.
12 付秋霞.舒适护理在椎体骨折护理中的应用.昆明医科大学学报,2013,34:173-175.
13 周雪梅.椎弓根钉固定结合伤椎体植骨成形治疗胸腰段椎体骨折的护理体会.实用临床医药杂志,2014,18:64-66.
14 丁莉.经皮骨水泥球珠堆积椎体成形术治疗椎体骨折的围手术期护理.国际护理学杂志,2013,32:2034-2035.
15 郭迎秋,郭少彤.椎体后凸成形术治疗周壁破损的骨质疏松性椎体压缩骨折的护理.中国实用护理杂志,2017,33:24-25.
16 李丽娜.胸腰椎体骨折患者围术期"三性"护理信息支持应用效果观察.东南国防医药,2018,20:90-92.
17 杨静.康复护理在胸腰段椎体骨折术后伴神经损伤患者中的应用.齐鲁护理杂志,2016,22:92-93.
18 姜艳,姚萍.图谱法康复训练对单纯性胸腰椎体骨折患者康复效果的影响.护理实践与研究,2015,12:146-147.
19 郭兰,管琳君.经皮椎体成形术治疗老年骨质疏松椎体压缩性骨折的护理.西部中医药,2016,29:127-128.
20 吴泳锐,陈秀芹.老年骨质疏松性椎体压缩性骨折经皮椎体成形术围手术期护理.中华全科医学,2015,13:310-312.