循证护理对交锁髓内钉治疗下肢骨折患者功能锻炼的影响..doc

循证护理对功能锻炼影响 Orthopaedic Department of Affiliated Hospital of Nantong University 【摘要】??目的??探讨循证护理对功能锻炼。??方法??将1?例随机分为对照组 ?例 及实验组 ?例 ?,对照组按骨科护理常规实施功能锻炼?,实验组应用循证护理方法实施功能锻炼。结果 观察肢肿、??结论??运用循证护理方法术后肢体肿、。Purpose: To explore the effect of evidence-based nursing on the results of progressive functional exercise of lower extremity fracture treated by intramedullary nailing. Methods: 120 patients with lower extremity fractures treated using intramedullary nailing were divided into two groups randomly: one was experimental group in which evidenced-nursing was performed 60 cases and the other was control group in which the conventional nursing was performed 60 cases . The clinical results including pain, swelling, rang of motion and radiological result of callus formation were evaluated. Results: The improvements were noticed in experimental group with regards to swelling and range of motion comparing with the conventional group p 0.01）. Conclusion: The evidence-based nursing is useful in shortening the swelling decrease time and improvement of the range of motion of joint in patients with lower extremity fracture treated using intramedullary nailing. 【关键词】??循证护理 功能锻炼??Key words: Evidence-based nursing, lower extremity fracture, intramedullary nailing, functional exercise. 交锁髓内钉适用于股骨、胫骨骨干各种类型稳定性或不稳定性骨折，是一种轴向型固定，具有固定力强、可防止骨折旋转、短缩、分离移位等优点，术后患者能早期活动，关节功能恢复快。［1］另外，交锁髓内钉对骨折端周围软组织损伤较小，负重时应力遮挡作用小，骨折端的应力得以传导而刺激骨痂生长，骨折愈合快，拔钉后再骨折率很低，因而是股骨、胫骨骨折治疗的优先选择，在临床上运用越来越广泛。循证护理是护理人员在计划其护理活动过程中?,审慎地、明确地、明智地将科研结论与其临床经验及病人愿望相结合的过程[]。为了提高术后病人功能锻炼效果?,促进病人早日康复?,我科20年月—20年1月将循证护理运用于术后病人早期功能锻炼实践中?,收到了较好的效果。现报道如下： 1??临床资料 1.1一般资料 我科200年月—20年1月共收治股骨骨折例，胫骨骨折例;例中开放性骨折例，陈旧性骨折不愈合例，多段骨折例。按AO分类:A型12例，B型18例，C型6例。开放性骨折根据Gustilo分类:型例，型例。新鲜闭合骨折～7天后手术，开放性骨折急诊清创，约1～2周，伤口无感染、创面稳定后手术。骨折粉碎明显、有骨缺损者或有骨不连者，清除骨折端软组织，取自体骨植骨。采用单盲法随机将病人分为对照组例及实验组例。两组年龄、性别、损伤类别、手术方式均无统计学意义 P 0.05 ?。 方法?实验组应用循证护理方法实施早期功能锻炼?,对照组按骨科护理常规实施功能锻炼。 循证护理 2.1 确立循证问题?,寻找循证支持?　循证护理小组成员寻找术后早期功能锻炼中的护理问题,将其特定化、结构化。本组病例具体为术后进行早期功能锻炼的时机、功能锻炼的内容与时间、如何减