早期預(yù)警性干預(yù)對(duì)股骨頸骨折患者應(yīng)激反應(yīng)及焦慮抑郁情緒的影響

陸瑩姿

摘要：目的 分析早期預(yù)警性干預(yù)作用于股骨頸骨折患者中的臨床效果及對(duì)其應(yīng)激反應(yīng)及焦慮抑郁情緒的影響。方法 選擇本院2018年5月-2020年5月期間的40例股骨頸骨折患者，隨機(jī)將其分為早期預(yù)警組與對(duì)照組，每組各20例。對(duì)照組給予常規(guī)圍手術(shù)期干預(yù)，早期預(yù)警組在對(duì)照組基礎(chǔ)上給予早期預(yù)警性干預(yù)。 比較兩組患者術(shù)前及術(shù)中生命體征（血壓、心率、呼吸等）、焦慮、抑郁情緒、并發(fā)癥發(fā)生率及滿意度。結(jié)果 早期預(yù)警組術(shù)中的血壓、心率、呼吸均顯著低于對(duì)照組 （P < 0.05 ）;早期預(yù)警組焦慮、抑郁自評(píng)量表評(píng)分及術(shù)后并發(fā)癥發(fā)生率低于對(duì)照組（P < 0.0 5）;滿意度高于對(duì)照組（P < 0.0 5）。結(jié)論 早期預(yù)警性干預(yù)可有效減輕股骨頸骨折患者的術(shù)中應(yīng)激反應(yīng)，并能明顯緩解患者焦慮抑郁情緒，減少術(shù)后并發(fā)癥的發(fā)生，具有臨床推廣價(jià)值。

關(guān)鍵詞：股骨頸骨折;早期預(yù)警性;應(yīng)激反應(yīng);焦慮;抑郁

【中圖分類(lèi)號(hào)】R816.8 【文獻(xiàn)標(biāo)識(shí)碼】A?【文章編號(hào)】1673-9026（2020）12-119-02

【Abstract】Objective To analyze the clinical effect of early warning intervention on patients with femoral neck fracture and its influence on stress response，anxiety and depression.Methods Forty patients with femoral neck fracture in our hospital from May 2019 to May 2020 were randomly divided into early warning group and control group，with 20 cases in each group.The control group was given routine perioperative intervention，and the early warning group was given early warning intervention on the basis of the control group.The vital signs （blood pressure，heart rate，breathing，etc.），anxiety，depression，complication rate and satisfaction were compared between the two groups before and during operation.Results Blood pressure，heart rate and respiration in early warning group were significantly lower than those in control group （P<0.05）; The scores of self-rating anxiety and depression scale and the incidence of postoperative complications in early warning group were lower than those in control group （P<0.05）.Satisfaction was higher than that of control group （P<0.05）.Conclusion Early warning intervention can effectively alleviate the stress reaction of patients with femoral neck fracture during operation，and can obviously relieve the anxiety and depression of patients，and reduce the occurrence of postoperative complications，which has clinical popularization value.

[Keywords] Femoral neck fracture; Early warning; Stress response; Anxiety; Depression

股骨頸骨折在臨床中是一種很常見(jiàn)的骨折類(lèi)型，以中老年人群好發(fā)，目前首選治療方案為手術(shù)治療。但由于對(duì)手術(shù)的不了解，且大多患者心理承受能力較差差，從而容易產(chǎn)生負(fù)性心理，加上創(chuàng)傷及手術(shù)的影響，會(huì)顯著增強(qiáng)患者的應(yīng)激反應(yīng)。若未予以有效的處理將會(huì)影響手術(shù)過(guò)程的順利及預(yù)后效果[1]。早期預(yù)警性護(hù)理干預(yù)是一種通過(guò)早期預(yù)警評(píng)估，從而可以早期發(fā)現(xiàn)隱患、預(yù)防各類(lèi)風(fēng)險(xiǎn)及并發(fā)癥的發(fā)生、有效提高醫(yī)療安全性的干預(yù)模式[2]，對(duì)于減輕患者應(yīng)激反應(yīng)及負(fù)性情緒具有明顯效果。基于此，本次研究將早期預(yù)警性干預(yù)應(yīng)用于股骨頸骨折患者中，并對(duì)其作用效果及對(duì)應(yīng)激反應(yīng)、焦慮抑郁情緒的影響進(jìn)行了分析探討，詳細(xì)報(bào)告如下。

l資料與方法

1.1一般資料

選擇本院2019年5月-2020年5月期間的40例股骨頸骨折患者，隨機(jī)將其分為早期預(yù)警組與對(duì)照組，每組各20例。對(duì)照組中男11例，女9例，年齡48 ～ 96歲，平均（73.34±6.12）歲;早期預(yù)警中男10例，女10例，年齡50 ～94歲，平均（73.52 ±6.26）歲。

納人標(biāo)準(zhǔn)：（1）經(jīng)臨床影像學(xué)檢查確診為股骨頸骨折;（2）符合手術(shù)指征;（3）術(shù)前住院時(shí)間>3d;（4）患者自愿接受本研究調(diào)查。