人工关节置换术患者并发症危险因素分析及护理效果

摘要

目的 探讨人工关节置换术患者出现并发症的危险因素,并分析围手术期护理对这些危险因素的影响.方法 收集2010年1月至2011年6月间接受人工关节置换术的40例患者资料进行回顾性分析,对差异有统计学意义的危险因素进行非条件Logistic回归分析,找出人工关节置换术出现并发症的独立危险因素.将2011年7月至2013年1月接受人工关节置换术并出现术后并发症的60例患者按分层随机分组法随机分成对照组和研究组,对照组采用常规护理,研究组针对危险因素进行围手术期护理干预,比较围手术期护理对患者并发症发生率的影响.结果 Logistic回归分析结果显示,术前合并症(β=1.643,OR =4.968)、细菌交叉感染(β=1.900,OR=6.319)、肢体制动时间过长(β=1.785,OR=5.658)、住院天数(β=1.699,OR=5.218)是人工关节置换术患者出现并发症的危险因素;经过围手术期护理干预研究组患者并发症发生率为13.33％,低于对照组的53.33％,两组比较差异有统计学意义(x2=1.800,P＜0.01).结论 术前合并症、细菌交叉感染、肢体制动时间过长、住院天数是人工关节置换术患者术后并发症的危险因素;围手术期护理可降低人工关节置换术患者术后并发症的发生率,在今后的临床实践中,应加强对患者围手术期的护理干预,减轻患者术后痛苦,尽可能地减少术后并发症的出现.%Objective To explore the risk factors of complications in patients with prosthetic replacement for joint,and analyze the effect of perioperative period nursing on the risk factors.Methods The data from 40 patients with prosthetic replacement for joint in our hospital from January 2010 to June 2011 were collected and retrospectively analyzed,and the risk factors with statistically significant differences were analyzed by the non-conditional logistic regression in order to find out the independent risk factors of complications in patients with prosthetic replacement for joint.Sixty prosthetic replacements for joint patients with postoperative complications from July 2011 to January 2013 were divided into the observation group and the control group according to the stratified random grouping.The control group received the routine nursing,and the observation group received the perioperative period nursing according to the risk factors.The effect of perioperative period nursing on the incidence rate of complications in patients was compared in two groups.Results The results of logistic regression showed that the risk factors of complications in patients with prosthetic replacement for joint were preoperative complications (β =1.643,OR =4.968),bacterial cross infection (β =1.900,OR =6.319),the longer time of lirnb braking (β =1.785,OR =5.658) and hospitalization days (β =1.699,OR =5.218).The incidence rate of complications was 13.33％ in the observation group,and was lower than 53.33％ in the control group,and the difference was statistically significant (x2 =1.800,P ＜ 0.01).Condusions Preoperative complications,bacterial cross infection,the longer time of limb braking,hospitalization days are the risk factors of complications in patients with prosthetic replacement for joint.The perioperative period nursing can reduce the incidence rate of complications in patients.In the future clinical practice,we should strengthen the nursing intervention during perioperative period,and reduce the pain of patients and the complication after operation as much as possible.