摘要
目的探讨骨折联络服务(FLS)模式对骨质疏松性椎体压缩骨折(OVCF)患者服药依从性、生活质量、疼痛及再骨折率的效果。方法采用前瞻性病例对照研究分析贵州省人民医院疼痛科2017年1月—2017年9月收治的117例OVCF患者资料。患者按照随机数字表法分为对照组58例,干预组59例。对照组采取常规护理,干预组在对照组的基础上,采用FLS模式干预至出院后3个月。于患者入、出院时及出院后1,3个月分别采用Morisky服药依从性量表比较患者服药依从性;采用健康调查简表(SF-36)评价生活质量,该量表共包含生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康8个维度;采用视觉模拟评分(VAS)评价患者疼痛情况;比较两组患者再骨折发生率。结果两组患者性别、年龄、糖尿病史、激素使用史、椎体骨折数/部位、致伤原因比较差异无统计学意义(P>0.05)。干预组出院后1,3个月Morisky服药依从性得分分别为(5.5±2.0)分、(6.3±1.8)分,均高于对照组的(3.5±2.2)分、(3.3±1.8)分(P<0.05);组内比较,各时相点差异均有统计学意义(P<0.05)。干预组患者出院后1,3个月SF-368个维度的得分均高于对照组(P<0.05);组内比较,各时相点差异均有统计学意义(P<0.05)。出院时、出院后1,3个月干预组疼痛VAS分别为(3.1±1.7)分、(1.8±1.3)分、(1.4±1.3)分,均低于对照组的(5.2±1.7)分、(3.6±1.6)分、(2.7±1.8)分(P<0.05);组内比较,各时相点差异均有统计学意义(P<0.05)。出院后1,3个月干预组患者再骨折率均为2%,对照组分别为3%、9%,两组差异均无统计学意义(P>0.05)。结论FLS模式能有效缓解OVCF患者的疼痛,提高患者出院后的服药依从性和生活质量,但不能降低出院后短期再骨折发生率。
Objective To investigate the effects of fracture liaison service(FLS)model on the medication compliance of patients,quality of life,pain and re-fracture rate in patients with osteoporotic vertebral compression fracture(OVCF).Methods A prospective case control study was conducted to analyze the clinical data of 117 OVCF patients admitted to Department of Pain of Guizhou Provincial People's Hospital from January 2017 to September 2017.According to the random table method,patients were divided into control group(58 patients)and intervention group(59 patients).Routine nursing was adopted in the control group,and fracture liaison service mode was adopted in the intervention group on the basis of the control group until 3 months after discharge.Morisky scale was used to compare the medication compliance of patients on admission,at discharge,1 month,and 3 months after discharge,and SF-36 was used to evaluate the quality of life.The SF-36 scale contained eight dimensions including physiological function,physiological performance,physical pain,overall health,vitality,social function,emotional function and mental health.Visual analogue scale(VAS)was used to evaluate the pain of patients.The re fracture rates of the two groups were compared.Results There were no significant differences between the two groups concerning gender,age,history of diabetes,history of hormone use,number of vertebral fractures,fracture site and cause of injury(P>0.05).In the intervention group,the medication compliance scores of patients in the first and third months after discharge were(5.5±2.0)points and(6.3±1.8)points,which were higher than those in the control group[(3.5±2.2)points and(3.3±1.8)points](P<0.05).Within each group,there were significant differences among the medication compliance scores at the different time points of evaluation(on admission,at discharge,1 month,and 3 months after discharge).The scores of the eight dimensions of the SF-36 scale in the intervention group were higher than those in the control group at 1st and 3rd months after discharge(P<0.05).Within each group,there were significant differences among the SF-36 scores at the different time points of evaluation.The pain scores of the intervention group at discharge and 1st and 3rd months after discharge were(3.1±1.7)points,(1.8±1.3)points,(1.4±1.3)points,all lower than those in the control group[(5.2±1.7)points,(3.6±1.6)points,(2.7±1.8)points](P<0.05).Within each group,there were significant differences among the pain scores at the different time points of evaluation.At 1st and 3rd months after discharge,the re-fracture rates of the intervention group were both 2%,and the those of the control group were 3%and 9%,respectively,showing no significant difference between the two groups(P>0.05).Conclusion The FLS model can effectively alleviate the pain of OVCF patients,improve the medication compliance and quality of life of patients after discharge,but it cannot reduce the short-term re fracture rate after discharge.
作者
罗兰
刘朝露
方茜
孙雯
Luo Lan;Liu Zhaolu;Fang Qian;Sun Wen(Department of Endocrinology,Guizhou Provincial People's Hospital,Guiyang 550002,China;Medical College,Jingchu University of Technology,Jingmen 448000,China;Department of Pain,Guizhou Provincial People's Hospital,Guiyang 550002,China;Department of Nursing,Guizhou Provincial People's Hospital,Guiyang 550002,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2019年第12期1120-1125,共6页
Chinese Journal of Trauma
基金
中国研究型医院学会护理分会临床护理研究及创新发明孵化基金项目(2017-20-12)。
