摘要
目的探讨在胫腓骨远端闭合骨折患者术前护理中体位干预对消肿的效果。方法选取2019年6月至2021年2月在广州市第一人民医院接受治疗的60例胫腓骨远端闭合骨折患者为本次研究对象,其中男39例、女21例,年龄18~65岁,根据患肢护理体位抬高角度和石膏固定方法不同分为4组(15°、30°、45°石膏夹板外固定组和30°改良石膏固定组),每组15例。15°、30°和45°石膏夹板外固定组患者入院后给予患肢石膏夹板外固定后不同抬高患肢角度,30°改良石膏固定组患者石膏固定远端至跖骨近端。观察采取不同消肿护理方法后,4组患者患肢消肿程度、消肿时间和疼痛评分。计量资料组间采用独立样本t检验和单因素方差分析,计数资料采用χ^(2)检验。结果15°、30°和45°石膏夹板外固定组术前消肿时间分别为(6.60±0.74)d、(5.73±0.46)d、(5.67±0.69)d,差异有统计学意义(F=3.43,P=0.04);30°改良石膏固定组术前消肿时间为(4.53±0.52)d,对比30°石膏夹板外固定组差异有统计学意义(t=6.69,P<0.05);4组患肢肿胀程度在入院后2 d左右达到最高值,分别为(5.30±0.79)cm、(4.98±0.56)cm、(5.09±0.62)cm和(4.90±0.60)cm。对比抬高患肢15°和45°,抬高患肢30°具有肿胀消退速度更快更好、改善疼痛更优和良好患肢舒适度的优点;同时改良足部石膏固定增加足部运动可使消肿治疗更进一步。结论对胫腓骨远端闭合骨折患肢术前消肿治疗中,抬高患肢30°和改善石膏固定解放足部远端,能有效促进患肢消肿、降低患者疼痛程度,具有参考价值。
Objective To explore the effect of body position intervention on detumescence in the preoperative nursing of patients with closed fractures of the distal tibiofibula.Methods A total of 60 patients with closed fractures of the distal tibiofibula who were treated in Guangzhou First People's Hospital from June 2019 to February 2021 were selected as the study subjects,including 39 males and 21 females,aged 18-65 years.The patients were divided into 4 groups(15°,30°,and 45°plaster splint external fixation group and 30°modified plaster fixation group)according to different elevation angles and plaster fixation methods of the affected limb,with 15 cases in each group.The patients in the 15°,30°,and 45°plaster splint external fixation group were given different elevation angles of the affected limb after plaster splint external fixation,and the patients in the 30°modified plaster fixation group had plaster fixation to the proximal metatarsal bone.After taking different detumescence nursing methods,the detumescence degree,detumescence time,and pain score of patients in the four groups were observed.The independent sample t test and one-way ANOVA were used for the measurement data among groups,andχ^(2) test was used for the count data.Results The preoperative detumescence time of the 15°,30°,and 45°plaster splint external fixation group were(6.60±0.74)d,(5.73±0.46)d,and(5.67±0.69)d,respectively,with a statistically significant difference(F=3.43,P=0.04);the preoperative detumescence time of the 30°modified plaster fixation group was(4.53±0.52)d,and there was a statistically significant difference compared with the 30°plaster splint external fixation group(t=6.69,P<0.05).The swelling degrees of the affected limb of the four groups reached the highest value about 2 days after admission,which were(5.30±0.79)cm,(4.98±0.56)cm,(5.09±0.62)cm,and(4.90±0.60)cm,respectively.Compared with elevating the affected limb 15°and 45°,elevating the affected limb 30°had the advantages of faster and better swelling resolution,better pain improvement,and better comfort of the affected limb.At the same time,modified foot plaster fixation and increased foot movement could further promote detumescence treatment.Conclusion Elevating the affected limb 30°and modified plaster fixation can effectively reduce the swelling degree of the affected limb and the degree of pain in the preoperative detumescence of the affected limb of patients with closed fractures of the distal tibiofibula.
作者
黄洁影
芦虎
朱建伟
Huang Jieying;Lu Hu;Zhu Jianwei(Department of Orthopaedics,Guangzhou First People's Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China)
出处
《国际医药卫生导报》
2022年第2期232-236,共5页
International Medicine and Health Guidance News
基金
2018年广州市卫生计生科技一般引导项目(20181A010004)
2019年广州市第一人民医院红棉计划项目(Q2019019)。
关键词
胫腓骨远端闭合骨折
体位
肿胀
石膏固定
Closed fractures of the distal tibiofibula
Body position
Swelling
Plaster fixation
