CAJ | 학술논문

目的：探讨分析人工关节置换术患者并发症危险因素分析及护理效果。方法收集2012年1月~2014年1月于浙江省中医院(以下简称“我：”)接受人工关节置换术40例患者的临床资料，采用单因素分析和多因素Logistic回归分析分析人工关节置换术术后发生并发症的危险因素。另选取2014年3月~2015年3月我院经人工关节置换术后出现并发症70例患者，随机分为实验组和对照组，每组各35例，给予对照组患者常规护理，针对独立危险因素给予实验组患者围术期的护理干预，对两组患者的术后并发症发生率情况进行比较。结果单因素分析结果显示，术后并发症发生与术前合并症、肢体制动时间过长、细菌交叉感染、住院时间有关(P<0.05)；多因素Logistic回归分析结果表明，存在术前的合并症(OR =4.967，95%CI：1.217~20.376，P=0.010)、住院的时间>15 d (OR =5.217，95%CI：2.692~10.175，P=0.000)、存在细菌交叉感染(OR =5.657，95%CI：2.487~12.892，P=0.014)、肢体制动的时间过长(OR =6.318，95%CI：3.252~12.299，P=0.021)为人工关节置换术后患者并发症发生的独立危险因素。接受围术期的护理干预后，实验组患者并发症的发生率(14.29豫)较对照组(51.43豫)显著降低，差异有高度统计学意义(P<0.01)。结论围术期的针对性护理能够显著帮助减少人工关节置换术术后患者的并发症发生率，具一定的临床推广价值。
목적：탐토분석인공관절치환술환자병발증위험인소분석급호리효과。방법수집2012년1월~2014년1월우절강성중의원(이하간칭“아：”)접수인공관절치환술40례환자적림상자료，채용단인소분석화다인소Logistic회귀분석분석인공관절치환술술후발생병발증적위험인소。령선취2014년3월~2015년3월아원경인공관절치환술후출현병발증70례환자，수궤분위실험조화대조조，매조각35례，급여대조조환자상규호리，침대독립위험인소급여실험조환자위술기적호리간예，대량조환자적술후병발증발생솔정황진행비교。결과단인소분석결과현시，술후병발증발생여술전합병증、지체제동시간과장、세균교차감염、주원시간유관(P<0.05)；다인소Logistic회귀분석결과표명，존재술전적합병증(OR =4.967，95%CI：1.217~20.376，P=0.010)、주원적시간>15 d (OR =5.217，95%CI：2.692~10.175，P=0.000)、존재세균교차감염(OR =5.657，95%CI：2.487~12.892，P=0.014)、지체제동적시간과장(OR =6.318，95%CI：3.252~12.299，P=0.021)위인공관절치환술후환자병발증발생적독립위험인소。접수위술기적호리간예후，실험조환자병발증적발생솔(14.29예)교대조조(51.43예)현저강저，차이유고도통계학의의(P<0.01)。결론위술기적침대성호리능구현저방조감소인공관절치환술술후환자적병발증발생솔，구일정적림상추엄개치。
Objective To explore the risk factors of complications in patients with prosthetic joint replacement and the nursing effect. Methods The clinical data of 42 patients with prosthetic joint replacement from January 2012 to Jan-uary 2014 in the TCM Hospital of Zhejiang Province ("our hospital"for short ) were collected, single factor analysis and Logistic regression analysis were uesd to analyze risk factors of complication after prosthetic joint replacement. And 70 patients with complications after prosthetic joint replacement in our hospital from March 2014 to March 2015 were se-lected and divided into the experimental group and control group, with 35 cases in each group. The patients in control group were given the routine nursing, and patients in experimental group were given perioperative period nursing ac-cording to the risk factors. The complications incidence between two groups were compared. Results The single factor analysis showed postoperative complications were connected with preoperative complications, bacteria cross infection, limbs braking time too long, hospital stays (P< 0.05). Logistic regression analysis showed postoperative complications (OR =4.967, 95%CI:1.217-20.376, P=0.010), hospital stays>15 d (OR =5.217, 95%CI: 2.692-10.175, P=0.000), bacteria cross infection (OR=5.657, 95%CI:2.487-12.892, P=0.014), limbs braking time too long (OR =6.318, 95%CI:3.252-12.299, P=0.021) were independent risk factors of complications after prosthetic joint replacement. The compli-cations incidence of experimental group (14.29%) was much lower than that of control group (51.43%), the difference was statistically significant (P<0.01). Conclusion Perioperative targeting nursing can significantly help reduce the rate of complications in patients with prosthetic joint replacement, which is worth for clinical expand.