CAJ | 학술논문

目的：分析人工假体置换术治疗高龄骨质疏松性股骨颈骨折的临床PBL护理模式、康复训练，研究、探讨促进该类病患早期恢复的护理模式、康复训练方法及注意事项。方法：2005年10月～2011年2月，对人工假体置换术治疗高龄骨质疏松性股骨颈骨折的病人结合改良的系统、全程、规范化康复训练及以问题为基础（ PBL）护理模式应用于病患组病例57例57髋（观察组），与同期进行未经改良的常规康复训练且结合常规康复护理模式病例54例54髋（常规组）进行回顾性对比研究，对2组病例的护理满意率、围手术期临床指标观察及术后不同时期（1个月、3个月、6个月、12个月FRS评分及Harris髋评分）髋关节功能及髋关节功能优良率结果进行分析。结果：术后随访时间13个月～5年，平均为22．8个月。围手术期观察组病例的护理满意率、髋关节功能优良率较对照组高，并发症发生率低；观察组较对照组在病人卧床时间、住院时间、使用助步器的时间等方面有优势且差异显著（P＜0．05）；观察组术后早期（术后6周、3个月）FRS评分及Harris髋评分较对照组高，功能恢复较常规组为快。结论：系统、全程、规范化康复训练及PBL护理模式的应用能增强病患的自理能力，提高护理质量，有利于患者术后更好、更快的恢复，具有临床易开展、病人易接受的优点，值得临床开展及推广。
목적：분석인공가체치환술치료고령골질소송성고골경골절적림상PBL호리모식、강복훈련，연구、탐토촉진해류병환조기회복적호리모식、강복훈련방법급주의사항。방법：2005년10월～2011년2월，대인공가체치환술치료고령골질소송성고골경골절적병인결합개량적계통、전정、규범화강복훈련급이문제위기출（ PBL）호리모식응용우병환조병례57례57관（관찰조），여동기진행미경개량적상규강복훈련차결합상규강복호리모식병례54례54관（상규조）진행회고성대비연구，대2조병례적호리만의솔、위수술기림상지표관찰급술후불동시기（1개월、3개월、6개월、12개월FRS평분급Harris관평분）관관절공능급관관절공능우량솔결과진행분석。결과：술후수방시간13개월～5년，평균위22．8개월。위수술기관찰조병례적호리만의솔、관관절공능우량솔교대조조고，병발증발생솔저；관찰조교대조조재병인와상시간、주원시간、사용조보기적시간등방면유우세차차이현저（P＜0．05）；관찰조술후조기（술후6주、3개월）FRS평분급Harris관평분교대조조고，공능회복교상규조위쾌。결론：계통、전정、규범화강복훈련급PBL호리모식적응용능증강병환적자리능력，제고호리질량，유리우환자술후경호、경쾌적회복，구유림상역개전、병인역접수적우점，치득림상개전급추엄。
Objective:Analysis the clinical PBL ( problem-based learning ) nursing method and the rehabilitation training in the pros-thetic replacement of the hip for the osteoporotic femoral neck fractures in elderly patients .Explore the nursing method and the rehabilita-tion training and its announcement to improve the quality of nursing and accelerate patients 'restoration.Methods:From Oct.2005 to Feb. 2011 , the patients suffered by the osteoporotic femoral neck fractures in the eldly were performed with the prosthetic replacement of the hip.The observation group (57 patients, 57 hips) was subjected to the modified PBL nursing method and the modified rehabilitation train-ing.The control group (54 patients, 54 hips) was subjected to routine nursing method and rehabilitation training at the same period .The comparative items included the satisfied rate about nursing , ambulatory time , length of hospital stay , time of use walking aid , complication incidence, the FRS scores and Harris scores after the operation .Results: All patients were followed from 13 to 60 months (mean 22.8 months) .More patients'were satisfied with nursing in the observation group .The higher excellent rate of hip function and low complica-tion incidence in the observation group .The observation group was found to have a significantly advantages of ambulatory time , length of hospital stay, time of use walking aid, complication incidence.(P<0.05).The FRS scores and Harris hip score at the early stage (6 weeks, 3 months after operation ) was significant statistically difference .It showed that the recovery of hip function was rapid in observa-tion group at the early stage .Conclusion:This modified method can enhance the patients'ability of self-control , improve the quality of nursing, improve the recovery of hip function and accelerate patients'restoration.It is featured with easier to accept , feasibility and easier to carry out.