术前手术室心理干预联合术中精准体位护理对PFNA老年股骨粗隆间骨折患者应激反应的影响OA
Impact of preoperative psychological intervention in operating room combined with intraoperative precise positioning nursing on stress responses in elderly patients with intertrochanteric femoral fracture undergoing PFNA surgery
目的 探讨术前手术室心理干预联合术中精准体位护理对行股骨近端防旋髓内钉(PFNA)手术的老年股骨粗隆间骨折患者围手术期应激反应及临床结局的影响.方法 采用前瞻性随机对照研究,选取 2024 年 11 月至2025 年 11 月启东市人民医院收治的 100 例拟行 PFNA 手术的老年股骨粗隆间骨折患者为研究对象,使用随机数字表法分为对照组和观察组,各 50 例.对照组实施围手术期常规护理,观察组在对照组基础上,加用术前手术室心理干预联合术中精准体位护理.比较 2 组生理应激指标、心理应激指标、围手术期并发症发生率、术后住院时间、Har-ris 髋关节功能评分及护理满意度.结果 入手术室即刻(T1)、手术开始后 30 min(T2),观察组的心率(HR)、收缩压(SBP)水平均低于对照组(P 均<0.05);术后 24 h(T3),观察组 SAS、SDS 评分均低于对照组(P 均<0.05).观察组围手术期并发症总发生率显著低于对照组,术后住院时间更短,术后 5 d 的 Harris 评分及护理满意度评分均显著高于对照组(P 均<0.05).结论 术前手术室心理干预联合术中精准体位护理的整合模式,能有效缓解行 PFNA 的老年股骨粗隆间骨折患者的生理及心理应激反应,降低并发症发生率,是一种有效的围手术期护理优化策略.
Objective To explore the impact of preoperative psychological intervention in the operating room combined with intraoperative precise positioning nursing on the perioperative stress responses and clinical outcomes in elderly patients with intertrochanteric femoral fracture undergoing surgical management by proximal femoral nail antirotation(PFNA).Methods A prospective randomized controlled study was conducted to select 100 elderly patients with intertrochanteric femoral fracture who underwent PFNA surgery at Qidong People's Hospital from November 2024 to November 2025 as the research subjects.They were randomly divided into a control group and an observation group using a random number table method,each comprising 50 patients.The control group received routine nursing during the perioperative period,while the observation group received preoperative psychological intervention in operating room combined with intraoperative precise positioning nursing on the basis of the nursing given to the control group.Physiological stress indicators,psychological stress indicators,incidence of perioperative complications,postoperative hospital stay,Harris Hip Score,and nursing satisfaction of the two groups were compared.Results Immediately upon entering the operating room(T1)and 30 min after surgical incision(T2),the average heart rate(HR)and systolic blood pressure(SBP)of the observation group were lower than those of the control group(P<0.05).At 24 h after surgery(T3),the SAS and SDS scores of the observation group were lower than those of the control group(P<0.05).The overall incidence of perioperative complications in the observation group was significantly lower than that in the control group,and the postoperative hospitalization time was shorter than that in the control group.The Harris Hip Score and nursing satisfaction score at 5 days after surgery were significantly higher than those in the control group(P<0.05).Conclusion The integrated model of preoperative psychological intervention in operating room combined with intraoperative precise positioning nursing can effectively alleviate the physiological and psychological stress responses of elderly patients with intertrochanteric femoral fracture undergoing PFNA surgery,and reduce the incidence of complications.It is an effective strategy for perioperative nursing optimization.
黄蓓蓓;李珍卫;陆宏伟;周永娣
启东市人民医院 启东肝癌防治研究所 南通大学附属启东医院,江苏 南通,226200启东市人民医院 启东肝癌防治研究所 南通大学附属启东医院,江苏 南通,226200启东市人民医院 启东肝癌防治研究所 南通大学附属启东医院,江苏 南通,226200启东市人民医院 启东肝癌防治研究所 南通大学附属启东医院,江苏 南通,226200
医药卫生
股骨粗隆间骨折老年人股骨近端防旋髓内钉心理干预体位护理
intertrochanteric femoral fractureelderlyproximal femoral nail antirotationpsychological interventionpositioning nursing
《中西医结合护理（中英文）》 2026 (6)
109-113,5
南通市卫生健康委员会科研课题(MSZ2024112)
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