中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2015年
7期
810-812
,共3页
左丹%刘娟%欧阳兰飞%符羽
左丹%劉娟%歐暘蘭飛%符羽
좌단%류연%구양란비%부우
临床路径%肩关节损伤%优质服务%满意率
臨床路徑%肩關節損傷%優質服務%滿意率
림상로경%견관절손상%우질복무%만의솔
Clinical pathway%Shoulder joint injury%High quality service%Satisfaction rate
目的：探讨临床路径对关节镜下治疗肩关节Bankart损伤复发性前向不稳的术后患者康复锻炼情况的影响。方法采用区组随机化分组方法,将80例关节镜下治疗肩关节复发性前向不稳的术后患者及其家属分为两组,试验组40例按照临床路径对患者进行术后宣教；对照组40例采用常规健康教育方法。对患者术后肩关节活动度、术后疼痛评分、护理工作满意率、患者日常生活自理能力及术后并发症(复发性不稳、骨纤维化、感染、关节内血肿)等进行记录并进行统计学分析。结果试验组肩关节活动度在患者术后第7天、术后1个月ASES及Constant-Murley评分分别为(93.86±8.67),(95.90±4.35)分；明显优于对照组的(63.42±10.85),(91.80±5.15)分,差异有统计学意义(t值分别为15.862,9.753；P<0.05)；术后第3天试验组患者 VAS 评分为(4.45±2.25)分,明显低于对照组的(5.50±3.75)分,差异有统计学意义(t=1.328,P<0.05)；患者术后自理能力Barthel指数评分比较,试验组为(85.26±12.96)分,明显高于对照组的(81.35±14.11)分,差异有统计学意义(t=10.236,P<0.05)；患者术后并发症如复发性不稳、骨纤维化、感染、关节内血肿等比较发现,试验组发生并发症仅1例,明显低于对照组的6例,差异有统计学意义(χ2=3.914,P<0.05)。结论采用临床路径能有效提高患者术后肩关节功能情况,减轻患者疼痛,减少术后并发症的发生,提高患者生活质量。
目的：探討臨床路徑對關節鏡下治療肩關節Bankart損傷複髮性前嚮不穩的術後患者康複鍛煉情況的影響。方法採用區組隨機化分組方法,將80例關節鏡下治療肩關節複髮性前嚮不穩的術後患者及其傢屬分為兩組,試驗組40例按照臨床路徑對患者進行術後宣教；對照組40例採用常規健康教育方法。對患者術後肩關節活動度、術後疼痛評分、護理工作滿意率、患者日常生活自理能力及術後併髮癥(複髮性不穩、骨纖維化、感染、關節內血腫)等進行記錄併進行統計學分析。結果試驗組肩關節活動度在患者術後第7天、術後1箇月ASES及Constant-Murley評分分彆為(93.86±8.67),(95.90±4.35)分；明顯優于對照組的(63.42±10.85),(91.80±5.15)分,差異有統計學意義(t值分彆為15.862,9.753；P<0.05)；術後第3天試驗組患者 VAS 評分為(4.45±2.25)分,明顯低于對照組的(5.50±3.75)分,差異有統計學意義(t=1.328,P<0.05)；患者術後自理能力Barthel指數評分比較,試驗組為(85.26±12.96)分,明顯高于對照組的(81.35±14.11)分,差異有統計學意義(t=10.236,P<0.05)；患者術後併髮癥如複髮性不穩、骨纖維化、感染、關節內血腫等比較髮現,試驗組髮生併髮癥僅1例,明顯低于對照組的6例,差異有統計學意義(χ2=3.914,P<0.05)。結論採用臨床路徑能有效提高患者術後肩關節功能情況,減輕患者疼痛,減少術後併髮癥的髮生,提高患者生活質量。
목적：탐토림상로경대관절경하치료견관절Bankart손상복발성전향불은적술후환자강복단련정황적영향。방법채용구조수궤화분조방법,장80례관절경하치료견관절복발성전향불은적술후환자급기가속분위량조,시험조40례안조림상로경대환자진행술후선교；대조조40례채용상규건강교육방법。대환자술후견관절활동도、술후동통평분、호리공작만의솔、환자일상생활자리능력급술후병발증(복발성불은、골섬유화、감염、관절내혈종)등진행기록병진행통계학분석。결과시험조견관절활동도재환자술후제7천、술후1개월ASES급Constant-Murley평분분별위(93.86±8.67),(95.90±4.35)분；명현우우대조조적(63.42±10.85),(91.80±5.15)분,차이유통계학의의(t치분별위15.862,9.753；P<0.05)；술후제3천시험조환자 VAS 평분위(4.45±2.25)분,명현저우대조조적(5.50±3.75)분,차이유통계학의의(t=1.328,P<0.05)；환자술후자리능력Barthel지수평분비교,시험조위(85.26±12.96)분,명현고우대조조적(81.35±14.11)분,차이유통계학의의(t=10.236,P<0.05)；환자술후병발증여복발성불은、골섬유화、감염、관절내혈종등비교발현,시험조발생병발증부1례,명현저우대조조적6례,차이유통계학의의(χ2=3.914,P<0.05)。결론채용림상로경능유효제고환자술후견관절공능정황,감경환자동통,감소술후병발증적발생,제고환자생활질량。
Objective To explore clinical pathway applied for shoulder joint operation under arthroscopy treated Bankart lesions of recurrent instability ( BLRI ) , and investigate the effect of postoperative rehabilitation exercise. Methods A total of 80 patients with BLRI under shoulder arthroscopy and their families were randomly divided into two groups on average: experimental group received clinical pathway for patients rehabilitation exercise and control group with routine health education. We recorded and statistically analyzed postoperative shoulder joint activity, postoperative pain score, nursing job satisfaction, activities of daily living and postoperative complications. Results The ASES and Constant-Murley scores of shoulder joint range of motion were (93. 86 ± 8. 67) and (95. 90 ± 4. 35) in the experimental group better than (63. 42 ± 10. 85) and (91.80±5.15)ofthecontrolgroupafter7daysandonemonthoperation(t=15.862,9.753;P<0.05). After 3 days operation, the VAS score was (4. 45 ± 2. 25) in the experimental group apparently lower (5. 50 ± 3. 75) in the control group (t=1. 328, P<0. 05), but the self-care ability (Barthel indexes) score was low, (85. 26 ± 12. 96) in the experimental group, and (81. 35 ± 14. 11) in the control group ( t=10. 236, P<0. 05). Comparing the postoperative complication of recurrent in stability, bone fibrillation, infection, the incidence of complication just was suffered one cases in the experimental group, but 6 cases in the control group (χ2 =3. 914, P<0. 05). Conclusions Using clinical pathway is an effective option for the patients to improve the quality of life and satisfaction rate of nurses, and it also can alleviate patients′ pain and reduce the postoperative complications.
