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目的观察股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的手术配合方法及效果。方法将68例老年股骨粗隆间骨折患者随机分为观察组和对照组各34例。所有患者均行PFNA内固定术治疗,观察组患者行精细化手术护理配合,对照组患者行常规手术护理配合。观察并比较2组患者的手术时间、术中出血量及术中不良事件的发生率,以及手术医师和患者对手术室护士手术配合的满意度。结果观察组患者的平均手术时间短于对照组,平均术中出血量少于对照组,差异均有统计学意义(P<0.05),且术中器械故障、手术器械传递失误、感染等不良事件的总发生率(5.88%)低于对照组(20.59%),差异有统计学意义(P<0.05)。观察组手术医师、患者对手术室护士手术配合的满意度依次为100.00%、94.12%,对照组依次为81.82%、79.41%,2组比较差异均具有统计学意义(P<0.05)。结论在老年股骨粗隆间骨折PFNA内固定术治疗中实施精细化手术护理配合能有效提高手术治疗效果,缩短手术时间,减少术中出血量,降低不良事件的发生率,更好地促进手术顺利进行。
Objective To observe the operative method and effect of proximal femoral nailing (PFNA) in the treatment of intertrochanteric fractures in the elderly. Methods Sixty-eight elderly intertrochanteric fractures were randomly divided into observation group and control group, 34 cases each. All patients underwent PFNA internal fixation. The patients in the observation group underwent meticulous surgery and the patients in the control group received routine surgical nursing. The duration of operation, the amount of intraoperative blood loss and the incidence of adverse events in the two groups were observed and compared. The satisfaction of surgeons and patients with operation nurses in operating room was also observed. Results The average operation time of the observation group was shorter than that of the control group, and the average blood loss was less than that of the control group (P <0.05). The intraoperative and mechanical device failures, surgical instrument transmission errors and infection (5.88%) was lower than the control group (20.59%), the difference was statistically significant (P <0.05). Satisfaction of the surgeons and patients in operating room nurses in the observation group was 100.00% and 94.12% respectively, followed by 81.82% and 79.41% in the control group, respectively. The differences between the two groups were statistically significant (P <0.05). Conclusion In the treatment of senile intertrochanteric fractures of PFNA, the implementation of meticulous nursing intervention can effectively improve the surgical treatment, shorten the operation time, reduce the amount of intraoperative bleeding, reduce the incidence of adverse events, and better to promote the smooth operation get on.