An analysis of the intervention effect of perioperative evidence-based nursing on orthopedic trauma patients’ vagal reflex

摘要

OBJECTIVE: to discuss the application value of evidence-based nursing (EBN) on orthopedic trauma patients’ perioperative vagus reflex intervention effect. PATIENTS AND METHODS: Eighty-six patients were selected, who were hospitalized in orthopedics department of our hospital because of trauma from March, 2013 to March, 2014. Then, they were divided into the control group (n = 41 cases) and the treatment group (n = 45 cases) according to random number table after obtaining the consent of the Hospital Ethics Committee and the informed consent of the patients as well as their relatives. Control group patients were treated with conventional nursing before, during and after operation, and treatment group patients were treated with EBN. Then, the incidence of vagal reflex on the two groups of patients was compared. HRV frequency domain was applied to analyze the differences of autonomic nervous function changes on the two groups of patients, and ELISA test was taken to detect the differences of the concentration change of serum TNF-alpha and IL-6. RESULTS: The prevalence of vagal reflex on patients in treatment group was significantly lower than that in the control group, with statistically significant difference (p < 0.05); low frequency (LF) and high frequency (HF) on patients from both groups decreased after treatment while LF/HF increased, and LF and HF on patients of the treatment group decreased more significantly and LF/HF increased more significantly than those of the control group, with statistically significant difference (p < 0.05); the concentration of TNF-alpha and IL-6 on both groups of patients after nursing also decreased, and the treatment group decreased more significantly, with statistically significant difference (p < 0.05). CONCLUSIONS: EBN could reduce the prevalence of vagal reflex to some extent on perioperative orthopedic trauma patients. It might be because EBN could improve vagal tone and reduce the concentration of TNF-alfa and IL-6.