基于循证医学联合策略优化管理模式在老年腰椎压缩性骨折患者术后的应用效果OACSTPCD
Application effects of strategy optimization management model based on evidence-based medicine in elderly patients with lum-bar compression fractures after surgery
目的 探究基于循证医学联合策略优化管理模式在老年腰椎压缩性骨折患者术后的应用效果.方法 选取2020年7月—2022年4月于首都医科大学附属北京朝阳医院行经皮椎体成形术(PVP)的老年腰椎压缩性骨折患者92例,按照数字表法随机分为观察组(n=46)和对照组(n=46).2组PVP术后均采用相同的一般治疗,此外观察组采用基于循证医学结合策略优化管理模式,对照组采用常规护理模式.观察并比较2组术后早期康复[采用日本骨科协会(JOA)评分、Barthe指数(BI)评分、视觉模拟评分(VAS)进行评估]、疾病认知度(采用健康知识调查表评分)、出院准备度(采用RHDS评分)、出院指导质量(采用QDTS评分)及并发症情况.结果 干预后,观察组JOA和Barthe指数(BI)评分均高于对照组(P＜0.05),VAS评分低于对照组(P＜0.05);观察组骨折预防、饮食管理、并发症处理、康复锻炼评分及疾病认知度总分均高于对照组(P＜0.05);观察组个人状态、适应能力和预期性支持评分及RHDS总分高于对照组(P＜0.05);观察组患者出院前实际获得内容、指导技巧及效果和出院指导质量(QDTS)总分高于对照组(P＜0.05);观察组疼痛、发热、腹胀便秘及并发症总发生率低于对照组(P＜0.05),但2组骨水泥渗漏和尿潴留发生率差异均无统计学意义(P＞0.05).结论 循证医学结合策略优化管理模式有助于老年腰椎压缩性骨折患者PVP术后恢复,有助于提高患者疾病认知度和出院准备情况,并降低相关并发症发生率.
Objective To explore the application effects of strategy optimization management model based on evidence-based medicine in elderly patients with lumbar compression fractures after surgery.Methods A total of 92 elderly patients with lumbar vertebral compression fracture who underwent percutaneous vertebroplasty(PVP)in Beijing Chaoyang Hospital Affilia-ted to Capital Medical University from July 2020 to April 2022 were enrolled.According to random number table method,they were divided into observation group(46 cases)and control group(46 cases).Both groups received the same general treatment after PVP.In addition,the observation group adopted a strategy optimization management model based on evidence-based med-icine,while the control group adopted a routine nursing model.The early postoperative recovery[assessed by Japanese Ortho-paedic Association(JOA)score,Barthe index(BI)score,visual analogue score(VAS)],disease awareness(health knowl-edge questionnaire score),readiness for discharge[Readiness for Hospital Discharge Scale(RHDS)],quality of discharge guidance[Quality of Discharge Teaching Scale(QDTS)]and complications in the two groups were observed and compared.Results After intervention,the scores of JOA and BI in the observation group were higher than those in the control group(P＜0.05),and VAS score was lower than that in the control group(P＜0.05);the scores of disease awareness(fracture prevention,diet management,complication management,rehabilitation exercise and its total score)were higher than those in the control group(P＜0.05);the scores of RHDS(personal status,adaptability,anticipatory support and its total score)were higher than those in the control group(P＜0.05);the scores of QDTS(actual content obtained,guidance skills and effect and its total score)were higher than those in the control group(P＜0.05).The incidence of pain,fever,abdominal distention and constipation,and total incidence of complications in the observation group(P＜0.05)were lower than those in the control group,but there was no significant difference in the incidence of bone cement leakage and urinary retention between the two groups(P＞0.05).Conclusion The strategy optimization management model based on evidence-based medicine is helpful to the recovery of elderly patients with lumbar vertebral compression fracture after PVP.It can improve disease awareness and readiness for discharge of patients,and reduce the incidence of related complications.
李杰;王明星;胡月
首都医科大学附属北京朝阳医院骨科,北京 100020
老年腰椎压缩性骨折经皮椎体成形术循证医学策略优化管理模式术后康复
elderlylumbar vertebral compression fracturepercutaneous vertebroplastyevidence-based medicinestrategy optimization management modelpostoperative rehabilitation
《老年医学与保健》 2024 (003)
834-839 / 6
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