标题：基于ERAS理念的护理干预对儿童肱骨髁上骨折术后功能恢复及预后的影响

      作者：穆林静 1，任娟侠 2，王魏荣 1    陕西省康复医院儿童康复科 1、骨与关节康复科 2，陕西 西安 710065

      卷次： 2021年32卷21期

      【摘要】 目的 研究基于加速康复外科(ERAS)理念的护理干预对儿童肱骨髁上骨折术后功能恢复及预后的影响。方法 选择2019年12月至2020年12月陕西省康复医院收治的94例肱骨髁上骨折术后患儿为研究对象，按照随机数字表法将患儿分为观察组和对照组各47例。对照组患儿给予常规护理干预，研究组患儿给予基于ERAS理念的护理干预，两组患儿均护理 2周。比较两组患儿护理后的效果，以及护理前后的膝关节功能(Hospital forspecial surgery，HSS)评分、肘关节活动度、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分，并比较两组患儿护理后的并发症发生情况。结果 观察组患儿护理后的总有效率为95.74%，明显高于对照组的76.60%，差异有统计学意义(P<0.05)；护理后，观察组患儿的HSS评分为(85.47±5.22)分，明显高于对照组的(70.36±5.53)分，差异有统计学意义(P<0.05)；护理后，观察组患儿的肘关节伸直活动度为(8.32±2.05)°，明显小于对照组的(15.39±3.52)°，屈曲活动度为(127.08±7.62)°，明显大于对照组的(113.64±8.70)°，差异均有统计学意义(P<0.05)；护理后，观察组患儿的SDS、SAS评分分别为(46.28±2.54)分、(42.19±0.84)分，明显低于对照组的(55.31±2.85)分、(50.32±0.96)分，差异均有统计学意义(P<0.05)；护理后，观察组患儿的并发症发生率为 6.38%，明显低于对照组的 27.66%，差异有统计学意义(P<0.05)。结论 基于ERAS理念的护理干预对儿童肱骨髁上骨折术后功能恢复具有积极作用，其不仅能明显缓解患儿术后不良情绪，提高患儿临床治疗效果，还能有效减少术后并发症发生，促进患儿早期恢复。
      【关键词】 肱骨髁上骨折；加速康复外科；护理干预；并发症；预后
      【中图分类号】 R473.72 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2846—04

Effect of nursing intervention based on the concept of ERAS on functional recovery and prognosis of childrenwith supracondylar fracture of humerus.
MU Lin-jing 1, REN Juan-xia 2, WANG Wei-rong 1. Department of ChildRehabilitation 1, Department of Bone and Joint Rehabilitation 2, Shanxi Provincial Rehabilitation Hospital, Xi'an 710065,Shaanxi, CHINA
【Abstract】 Objective To study the effect of nursing intervention based on the concept of enhanced recovery af-ter surgery (ERAS) on functional recovery and prognosis of children with supracondylar fracture of humerus, to provideguidance for clinical treatment. Methods A total of 94 children with supracondylar fractures of the humerus after sur-gery, who admitted to Shanxi Provincial Rehabilitation Hospital from December 2019 to December 2020, were selectedand divided into the observation group and control group according to random number table method, with 47 cases ineach group. The control group was given routine nursing intervention, and the study group was given nursing interven-tion based on the concept of ERAS, both groups of children were nursing for 2 weeks continuously. The effect of the twogroups after nursing, the knee joint function (Hospital for special surgery, HSS) score, elbow joint mobility, depressionself-rating scale (SDS) score, anxiety self-rating scale (SAS) score of the two groups before and after nursing, and thecomplications of the two groups after nursing were compared. Results After nursing, the total effective rate of treat-ment for children in the observation group was 95.74%, which was significantly higher than 76.60% in the control group(P<0.05); the HSS score of the observation group was (85.47±5.22) points, which was significantly higher than (70.36±5.53) points of the control group (P<0.05); the elbow joint extension range of the observation group was (8.32±2.05)°,which was significantly smaller than (15.39 ± 3.52)° of the control group, and the flexion range was (127.08 ± 7.62)° ,which was significantly greater than (113.64±8.70)° of the control group (P<0.05); the SDS and SAS scores of the obser-vation group were (46.28 ± 2.54) points and (42.19 ± 0.84) points, which were significantly lower than corresponding(55.31±2.85) points and (50.32±0.96) points of the control group (P<0.05); the incidence of complications in the observa-tion group was 6.38%, which was significantly lower than the 27.66% in the control group (P<0.05). Conclusion Nurs-ing intervention based on the concept of ERAS has a positive effect on postoperative functional recovery of childrenwith supracondylar humeral fractures. It can not only significantly alleviate the unhealthy mood of children after surgery,·护理·doi:10.3969/j.issn.1003-6350.2021.21.033基金项目：陕西省科学技术研究发展计划项目(编号：2016YFJH2-03)