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循证护理模式用于下颌骨骨折患者术后护理的临床观察

徐少君 徐旭 严钦 范丽琴

徐少君, 徐旭, 严钦, 范丽琴. 循证护理模式用于下颌骨骨折患者术后护理的临床观察[J]. 中华全科医学, 2022, 20(8): 1434-1437. doi: 10.16766/j.cnki.issn.1674-4152.002616
引用本文: 徐少君, 徐旭, 严钦, 范丽琴. 循证护理模式用于下颌骨骨折患者术后护理的临床观察[J]. 中华全科医学, 2022, 20(8): 1434-1437. doi: 10.16766/j.cnki.issn.1674-4152.002616
XU Shao-jun, XU Xu, YAN Qin, FAN Li-qin. Observe on the clinical effect of evidence-based nursing model for postoperative nursing of patients with mandibular fracture[J]. Chinese Journal of General Practice, 2022, 20(8): 1434-1437. doi: 10.16766/j.cnki.issn.1674-4152.002616
Citation: XU Shao-jun, XU Xu, YAN Qin, FAN Li-qin. Observe on the clinical effect of evidence-based nursing model for postoperative nursing of patients with mandibular fracture[J]. Chinese Journal of General Practice, 2022, 20(8): 1434-1437. doi: 10.16766/j.cnki.issn.1674-4152.002616

循证护理模式用于下颌骨骨折患者术后护理的临床观察

doi: 10.16766/j.cnki.issn.1674-4152.002616
基金项目: 

浙江省医药卫生科技计划项目 2018KY878

详细信息
    通讯作者:

    徐少君, E-mail: hhxsjhyt@163.com

  • 中图分类号: R473.78 R782.05

Observe on the clinical effect of evidence-based nursing model for postoperative nursing of patients with mandibular fracture

  • 摘要:   目的  观察循证护理模式用于提高下颌骨骨折患者术后康复水平的临床效果。  方法  选择2018年1月—2021年6月温州医科大学附属衢州医院和浙江大学医学院附属第二医院收治的120例下颌骨骨折患者为研究对象,按照入院时间将患者分为对照组(60例)和研究组(60例),2组患者均进行小型钛板颌骨内固定术治疗,对照组患者术后实施常规护理干预,研究组患者实施循证护理干预。记录患者手术时间、术中出血量、住院时间和骨折愈合时间等手术指标,于术后3个月和6个月测定或评估患者咀嚼能力、牙齿咬合力、生活质量和心理健康状况,评价患者口腔卫生健康状况,观察患者术后并发症发生情况。  结果  研究组住院时间[(11.59±1.27)d vs.(16.94±1.45)d]和骨折愈合时间[(41.28±4.09)d vs.(49.62±4.31)d]均显著短于对照组(t=21.543、10.579,均P<0.001);研究组术后3个月咀嚼功能、牙齿咬合力和SF-36评分均显著高于对照组水平(均P<0.001),而2组术后6个月上述指标差异均无统计学意义(均P>0.05);研究组术后6个月HAMA和HAMD评分、PI、DI、GI和SBI均显著低于对照组(均P<0.001);研究组术后并发症总体发生率(5.00%,3/60)显著低于对照组水平(18.33%,11/60,χ2=5.175,P=0.023)。  结论  循证护理模式可有效缩短下颌骨骨折患者术后康复周期,提高术后早期下颌运动功能水平和生活质量,减轻患者心理负担,改善口腔卫生健康状况,有助于减少术后并发症。

     

  • 表  1  2组下颌骨骨折患者一般资料比较

    Table  1.   Comparison of general data of mandibular fracture patients between two groups

    组别 例数 年龄(x±s,岁) 性别(例) 致伤原因(例) 骨折部位(例)
    男性 女性 交通事故 高空坠落 撞击 颏孔部 下颌骨正中 下颌角 髁状突部
    对照组 60 38.26±3.54 36 24 35 19 6 25 12 11 12
    研究组 60 37.82±3.61 38 22 33 22 5 23 15 12 10
    统计量 0.663a 0.141b 0.369b 0.509b
    P 0.509 0.707 0.831 0.917
    注:at值,b为χ2值。
    下载: 导出CSV

    表  2  2组下颌骨骨折患者手术治疗指标比较(x±s)

    Table  2.   Comparison of surgical treatment indexes of mandibular fractures between two groups(x±s)

    组别 例数 手术时间(min) 术中出血量(mL) 住院时间(d) 骨折愈合时间(d)
    对照组 60 86.27±7.62 41.59±4.52 16.94±1.45 49.62±4.31
    研究组 60 85.94±7.53 40.83±4.47 11.59±1.27 41.28±4.09
    t 0.229 0.934 21.543 10.579
    P 0.819 0.352 <0.001 <0.001
    下载: 导出CSV

    表  3  2组下颌骨骨折患者术后咀嚼功能、牙齿咬合力及生活质量比较(x±s)

    Table  3.   Comparison of postoperative masticatory function, bite force and quality of life between two groups of patients with mandibular fracture(x±s)

    组别 例数 咀嚼功能(%) 牙齿咬合力(Ibs) SF-36评分(分)
    术后3个月 术后6个月 术后3个月 术后6个月 术后3个月 术后6个月
    对照组 60 74.52±4.07 81.95±4.62 128.35±6.26 141.68±8.21 76.85±4.71 83.96±5.33
    研究组 60 79.76±4.43 82.71±4.67 139.36±8.15 143.49±8.37 83.41±5.26 85.07±5.39
    t 6.756 0.894 8.318 1.194 7.221 1.125
    P <0.001 0.373 <0.001 0.235 <0.001 0.263
    下载: 导出CSV

    表  4  2组下颌骨骨折患者护理前后心理状况比较(x±s,分)

    Table  4.   Comparison of psychological status of mandibular fracture patients before and after nursing(x±s, scores)

    组别 例数 HAMA评分 HAMD评分
    护理前 术后6个月 护理前 术后6个月
    对照组 60 21.34±1.96 12.52±1.28a 22.59±2.07 13.41±1.45a
    研究组 60 20.97±1.93 9.63±1.02a 22.47±2.04 10.72±1.16a
    t 1.076 13.615 0.311 11.108
    P 0.284 <0.001 0.756 <0.001
    注:与同组护理前比较,aP<0.05。
    下载: 导出CSV

    表  5  2组下颌骨骨折患者术后PI、DI、GI和SBI比较(x±s)

    Table  5.   Comparison of postoperative PI, DI, GI and SBI between the two groups of patients with mandibular fracture(x±s)

    组别 例数 PI DI GI SBI
    对照组 60 1.79±0.18 1.68±0.17 1.12±0.14 1.86±0.19
    研究组 60 1.58±0.16 1.47±0.15 0.79±0.06 0.92±0.10
    t 6.650 7.140 15.670 32.934
    P <0.001 <0.001 <0.001 <0.001
    下载: 导出CSV
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  • 收稿日期:  2021-11-29
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