标题：体位管理对老年髋部骨折患者术后髋关节功能恢复及并发症的影响

      作者：朱祥萍 1，吉辉 2，雷德会 1    (攀枝花市中西医结合医院骨科 1、护理部 2，四川 攀枝花 617000)

      卷次： 2018年29卷7期

      【摘要】 目的 探讨体位管理对老年髋部骨折患者术后髋关节功能恢复及并发症的影响，为老年髋部骨折患者的康复提供参考。方法 选取2015年1月至2016年12月期间攀枝花市中西医结合医院诊治的髋部骨折行人工髋关节置换术的老年患者100例，采用随机数表法分为对照组和观察组，每组50例。对照组给予常规护理，观察组在常规护理基础上给予体位管理，比较两组患者术后并发症的发生情况，以及术后1个月、3个月、6个月时髋关节功能恢复情况(Harris髋关节功能评分)及日常生活能力(Barthel指数)。结果 对照组患者术后并发症发生率为20.0%，明显高于观察组的6.0%，差异有统计学意义(P<0.05)；术后1个月时Harris髋关节功能评分及优良率两组比较差异均无统计学意义(P>0.05)。3个月、6个月时Harris髋关节功能评分及优良率观察组分别为(80.4±11.2)分、(89.8±10.8)分、80.0%、96.0%，均明显高于对照组的(73.1±10.0)分、(80.2±11.2)分、60.0%、76.0%，差异均有统计学意义(P<0.05)；术后1个月时Barthel指数评分两组比较差异无统计学意义(P>0.05)；3个月、6个月时Barthel指数评分观察组分别为(80.4±10.6)分、(89.1±8.7)分，明显高于对照组的(72.1±11.1)分、(83.7±8.8)分，差异均有统计学意义(P<0.05)。结论 对老年髋部骨折患者围术期采取体位管理有助于促进髋关节功能恢复和降低并发症的发生，提高患者日常生活能力。
      【关键词】 髋部骨折；体位管理；老年；髋关节功能；并发症
      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2018）07—1034—03

Effect of body position management on postoperative hip function recovery and complications of elderly patientswith hip fracture.
ZHU Xiang-ping 1, JI Hui 2, LEI De-hui 1. Department of Orthopedics 1, Department of Nursing 2,Panzhihua Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Panzhihua 617000, Sichuan, CHINA
【Abstract】 Objective To investigate the effect of body position management on postoperative hip function re-covery and complications in elderly patients with hip fracture, and to provide reference for recovery of elderly patientswith hip fracture. Methods A total of 100 elderly patients with hip fracture who underwent artificial hip arthroplasty inPanzhihua Hospital of Integrated Traditional Chinese Medicine and Western Medicine form January 2015 to December2016 were selected. They were randomly divided into the control group and observation group accroding to random num-ber table, with 50 patients in each group. The control group was given routine nursing care, and the observation groupwas given position management on the basis of routine nursing. The incidence of postoperative complications, and the re-covery of hip function (Harris hip function score) at 1 month, 3 months and 6 months after operation, and daily livingability (Barthel index) were compared between the two groups. Results Postoperative complication rate of observationgroup was 20.0%, which was significantly higher than 6.0% of control group (P<0.05). There were no significant differ-ences in Harris hip function score and excellent rate between the two groups at 1 month after operation (P>0.05). TheHarris hip function score and excellent rate at 3 months and 6 months in observation group were respectively (80.4±11.2), (89.8±10.8), 80.0% and 96.0%, which were significantly higher than (73.1±10.0), (80.2±11.2), 60.0% and 76.0%in control group (P<0.05). There were no significant differences in Barthel index score between the two groups at 1month after operation (P>0.05). Barthel index score at 3 months and 6 months in observation group were respectively(80.38±10.64) and (89.1±8.7), which were significantly higher than (72.1±11.1) and (83.7±8.8) in control group (P<0.05).Conclusion Body position management is helpful to promote the recovery of hip joint function, reduce the occurrenceof complications, and improve the daily living ability for perioperative period in elderly patients with hip fracture.
      【Key words】 Hip fracture; Body position management; Elderly; Hip function; Complications·护 理·doi:10.3969/j.issn.1003-6350.2018.07.049基金项目：四川省科技厅项目(编号：14JC0082)