The operating room nursing effect of elderly patients with intertrochanteric fractures of the femur
老年股骨转子间骨折患者的手术室护理效果

摘要

目的 探讨针对性手术室护理干预在老年股骨转子间骨折患者围术期的应用效果，为提升此类患者手术安全性及预后质量提供参考依据。方法 以2023年1月至2024年12月我院收治的86例老年股骨转子间骨折患者为研究对象，通过随机数字表法将其划分为对照、观察两组，每组各43例，对照组执行手术室常规护理流程，观察组则采用围术期针对性手术室护理干预策略。比较两组血清去甲肾上腺素、肾上腺素、皮质醇水平及心率、平均动脉压及术后非预期病症出现率。结果 观察组术后各类非预期病症的总出现率显著低于对照组，组间差异经统计学分析具有意义（P<0.05）；术前1日，两组血清去甲肾上腺素、肾上腺素、皮质醇水平，以及心率、外周动脉平均灌注压的数值对比，均无统计学差异（P>0.05）。出麻醉恢复室时，两组的血清相关指标水平均较术前升高，但观察组各指标数值明显更低；且观察组的心率、外周动脉平均灌注压也显著低于对照组，这些组间差异均具有统计学意义（P<0.05）。结论 为老年股骨转子间骨折患者实施个体化手术室护理干预，可有效缩减手术时长、减少术中失血量，进而降低术后各类额外病症的出现概率，加快患者康复进程，同时提升护理满意度，具有较高的临床应用价值。

Abstract

Objective To explore the application effect of targeted operating room nursing intervention in the perioperative period of elderly patients with intertrochanteric fractures of the femur, and to provide a reference basis for improving the surgical safety and prognosis quality of such patients.
Methods A total of 86 elderly patients suffering from intertrochanteric fractures of the femur and admitted from January 2023 to December 2024 were selected as the research cohort. They were divided into two groups—the control group and the observation group—through the random number table method, with 43 patients in each group. The control group got standard operating room nursing care, and the observation group was given targeted nursing care in the operating room during the perioperative phasereceived targeted perioperative operating room nursing intervention. The levels of serum norepinephrine, epinephrine, cortisol, heart rate, mean arterial pressure and the likelihood of complications was compared across the two groups.
Results The total rate of complications after surgery in the observation group was clearly lower than that in thecontrol group, and the difference was statistically significant (P<0.05). One day before, there was no statistically significant difference in the levels of serum norepinephrine, epinephrine, cortisol, heart rate and mean arterial pressure between the two groups (P>0.05). When leaving the PACU, the levels of serum norepinephrine, epinephrine and cortisol in both groups were higher than those before the operation, but the levels of each index The values of the relevant indicators in the observation group were obviously lower than those in the control group. Moreover, the heart rate and vascular average perfusion pressure in the observation group were significantly lower than those in the control group, and the discrepancies between the two groups were statistically significant (P<0.05).
Conclusion   The adoption of targeted perioperative nursing measures in the operating room for elderly patients diagnosed with intertrochanteric femoral fractures of the femur can effectively shorten the operation time, reduce intraoperative bleeding, lower the risk of postoperative complications, accelerate the recovery process of patients, and improve nursing satisfaction at the same time. It has high clinical application value.