高龄股骨颈骨折患者围术期护理

摘要

Objective: To analyze the features of perioperative nursing for elder patients with femoral neck fracture who over the age of 80, and provide insight into the treatment care for elder patients. Methods: Retrospective study was performed of 61 cases of femoral neck fracture patients over the age of 80 receiving surgery during the period from June 2000 to June 2008. Care providing included preoperative health education, nichetargeting psychological care. Heart condition of the patients during and after operation was monitored, and blood pressure and blood sugar level were controlled. The vital signs after operation and sensorimotor distal limb blood circulation were closely observed, and the nursing of complications such as bedsores, lung infections, urinary tract infection and deep venous thrombosis were strengthened. Results: 61 patients were successfully operated, discharged with crutches or a walker and without incision infection and symptomatic deep venous thrombosis. Patients were able to sit up 3 to 5 day after operation and ambulate with crutches 5 to 10 days after operation. There occurred 6 cases of electrolyte disturbance, 4 cases of postoperative pulmonary infection, 3 cases of hy -potension, 2 cases of cardiac insufficiency, 2 cases of atrial fibrillation, 2 cases of stress ulcer, 1 case of postoperative uri -nary tract infection, and 1 case of bedsore. After active treatment and care, the symptoms of all patients improved. Conclusion: Patients with femoral neck fracture over the age of 80 should be given surgical treatment as early as possible to shorten the time in bed. Thus reasonable and effective perioperative nursing for patients with femoral neck fracture over the age of 80 is an important guarantee of successful operation.%目的:分析80岁以上高龄股骨颈骨折患者的围术期护理,总结围术期的特点,对今后高龄患者的治疗护理提供帮助.方法:回顾性研究2000年6月～2008年6月我院手术治疗的61例80岁以上的股骨颈骨折患者.术前对其进行健康教育,采取有针对性的心理护理.术中、术后监测心脏情况,控制血压、血糖.术后严密观察生命体征、患肢远端感觉运动血循环,并加强对压疮、肺部感染、泌尿系感染、深静脉血栓等并发症的护理.结果:61例患者均顺利完成手术,扶拐或助步器出院,切口无感染,无症状性下肢深静脉血栓形成.术后3～5 d坐起,5～10 d扶拐下地活动.术后并发症为电解质紊乱6例,肺部感染4例,低血压3例,心功能不全2例,房颤2例,应激性溃疡2例,泌尿系感染1例,压疮1例,均经积极治疗和护理后好转.结论:只要80岁以上高龄股骨颈骨折患者身体条件许可,应尽早手术治疗以缩短卧床时间,所以合理有效的围术期护理是80岁以上高龄股骨颈骨折患者手术成功的一个重要保障.