中医饮食护理对股骨颈骨折内固定术后康复效果的影响
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摘要
目的:观察中医饮食护理对股骨颈骨折空心螺钉内固定术后患者康复的影响。方法:将114例股骨颈骨折空心螺钉内固定术后患者随机分为对照组和观察组各57例。2组均施予空心螺钉内固定术,术后给予预防深静脉血栓形成、防压疮、防便秘和感染的综合护理措施,观察组分期并结合辨证给予中医饮食护理指导。2组患者出院后均连续随访6月。于术后1个月、3个月、6个月评定2组患者的Harris髋关节功能评分,记录骨折延迟愈合、骨不连、股骨头坏死和退钉等并发症的发生情况,统计患者的护理满意度,计算患者的平均骨折愈合时间。结果:术后6个月,观察组的髋关节功能恢复情况优于对照组(P <0.05);观察组术后1个月、3个月、6个月的Harris评分均高于对照组(P <0.01)。观察组骨折延迟愈合、骨不连、股骨头坏死、退钉等并发症的总发生率为22.39%,低于对照组的42.11%,差异有统计学意义(P <0.05)。观察组护理满意度评分高于对照组(P <0.01),平均骨折愈合时间短于对照组(P <0.01)。结论:对股骨颈骨折内固定术后患者分期进行中医饮食护理指导,可以起到促进骨折愈合和髋关节功能恢复的作用,且能减少并发症的发生,缩短骨折愈合的时间,提高患者对护理工作的满意度。
Objective:To observe the effect of dietary nursing of Chinese medicine on the rehabilitation of patients after the treatment for femoral neck fracture by internal fixation with cannulated screws. Methods:A total of 114 cases of patientsafter the treatment for femoral neck fracture by internal fixation with cannulated screws were randomly divided into the control group and the observation group,57 cases in each group. Both groups received internal fixation with cannulated screws and were given comprehensive nursing measures to prevent deep venous thrombosis, pressure sores, constipation and infections. The observation group was instructed with dietary nursing guidance of Chinese medicine by stages according to syndrome differentiation. The two groups were followed up for six months after discharge. One month,three months and six months after operation, the Harris hip scores were evaluated in both groups, the complications such as delayed union,nonunion, necrosis of femoral head and screw loosening were recorded, the nursing satisfaction of the patients was counted,and the average healing time of the fractures was calculated. Results:Six months after operation,the recovery of the hip joint function in the observation group was better than that in the control group(P < 0.05). One month,three months and six months after operation,the Harris hip scores in the observation group were higher than those in the control group(P <0.01). The total incidence rate of complications such as delayed union, nonunion, necrosis of femoral head and screw loosening was 22.39% in the observation group, lower than that of 42.11% in the control group, the difference being significant(P < 0.05). The score of nursing satisfaction in the observation group was higher than that in the control group(P <0.01),the average healing time of the fractures in the observation group was shorter than that in the control group(P < 0.01).Conclusion:The dietary nursing guidance of Chinese medicine by stages for the patients after the treatment for femoral neck fracture by internal fixation with cannulated screws can promote fracture healing and the recovery of hip function, reduce complications and shorten fracture healing time as well as improve the nursing satisfaction of the patients.
Objective:To observe the effect of dietary nursing of Chinese medicine on the rehabilitation of patients after the treatment for femoral neck fracture by internal fixation with cannulated screws. Methods:A total of 114 cases of patientsafter the treatment for femoral neck fracture by internal fixation with cannulated screws were randomly divided into the control group and the observation group,57 cases in each group. Both groups received internal fixation with cannulated screws and were given comprehensive nursing measures to prevent deep venous thrombosis, pressure sores, constipation and infections. The observation group was instructed with dietary nursing guidance of Chinese medicine by stages according to syndrome differentiation. The two groups were followed up for six months after discharge. One month,three months and six months after operation, the Harris hip scores were evaluated in both groups, the complications such as delayed union,nonunion, necrosis of femoral head and screw loosening were recorded, the nursing satisfaction of the patients was counted,and the average healing time of the fractures was calculated. Results:Six months after operation,the recovery of the hip joint function in the observation group was better than that in the control group(P < 0.05). One month,three months and six months after operation,the Harris hip scores in the observation group were higher than those in the control group(P <0.01). The total incidence rate of complications such as delayed union, nonunion, necrosis of femoral head and screw loosening was 22.39% in the observation group, lower than that of 42.11% in the control group, the difference being significant(P < 0.05). The score of nursing satisfaction in the observation group was higher than that in the control group(P <0.01),the average healing time of the fractures in the observation group was shorter than that in the control group(P < 0.01).Conclusion:The dietary nursing guidance of Chinese medicine by stages for the patients after the treatment for femoral neck fracture by internal fixation with cannulated screws can promote fracture healing and the recovery of hip function, reduce complications and shorten fracture healing time as well as improve the nursing satisfaction of the patients.
引文
[1]姜超,梅炯.股骨颈骨折分型的研究历史与展望[J].中国矫形外科杂志,2014,22(10):902-906.
[2]钟楚楠,张瑜哲,刘继军.续骨活血汤联合空心螺钉内固定治疗股骨颈骨折86例[J].中药药理与临床,2016,32(1):186-188.
[3]陈彦均,李希文,刘军,等.中医治疗股骨颈骨折的研究进展[J].中国中医药现代远程教育,2016,14(21):141-144.
[4]郭跃生.中医食疗在骨折治疗中的应用[J].河南中医,2006,26(4):78-79.
[5]胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2012:1153-1156.
[6]Nilsdotter A,Bremander A.Measures of hip function and symptoms:Harris Hip Score(HHS),Hip Disability and Osteoarthritis Outcome Score(HOOS),Oxford Hip Score(OHS),Lequesne Index of Severity for Osteoarthritis of the Hip(LISOH),and American Academy of Orthopedic Surgeons(AA)[J].Arthritis&Research,2011,63(S11):S200-S207.
[7]吴作培,孙贵新.骨不连治疗的研究与技术应用进展[J].中国组织工程研究,2013,17(35):6333-6338.
[8]于薇.中医学理论在骨折患者饮食调护中的作用[C]//第13届全国中西医结合骨伤科学术研讨会论文集.大连:[出版者不详],2005:585-586.
[2]钟楚楠,张瑜哲,刘继军.续骨活血汤联合空心螺钉内固定治疗股骨颈骨折86例[J].中药药理与临床,2016,32(1):186-188.
[3]陈彦均,李希文,刘军,等.中医治疗股骨颈骨折的研究进展[J].中国中医药现代远程教育,2016,14(21):141-144.
[4]郭跃生.中医食疗在骨折治疗中的应用[J].河南中医,2006,26(4):78-79.
[5]胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2012:1153-1156.
[6]Nilsdotter A,Bremander A.Measures of hip function and symptoms:Harris Hip Score(HHS),Hip Disability and Osteoarthritis Outcome Score(HOOS),Oxford Hip Score(OHS),Lequesne Index of Severity for Osteoarthritis of the Hip(LISOH),and American Academy of Orthopedic Surgeons(AA)[J].Arthritis&Research,2011,63(S11):S200-S207.
[7]吴作培,孙贵新.骨不连治疗的研究与技术应用进展[J].中国组织工程研究,2013,17(35):6333-6338.
[8]于薇.中医学理论在骨折患者饮食调护中的作用[C]//第13届全国中西医结合骨伤科学术研讨会论文集.大连:[出版者不详],2005:585-586.