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骨科康复护理门诊在儿童肱骨髁上骨折术后延续护理中的实践与成效
引用本文:陈晓艳,周利华,方继红,尹莹,李敦辉,段勇贤. 骨科康复护理门诊在儿童肱骨髁上骨折术后延续护理中的实践与成效[J]. 中华全科医学, 2022, 20(7): 1244-1247. DOI: 10.16766/j.cnki.issn.1674-4152.002568
作者姓名:陈晓艳  周利华  方继红  尹莹  李敦辉  段勇贤
作者单位:1.安徽省儿童医院儿童骨科,安徽 合肥 230051
基金项目:安徽省卫生健康委科研基金项目AHWJ2021b143
摘    要:  目的  探讨基于骨科康复门诊的延续护理模式对儿童肱骨髁上骨折康复的干预效果。  方法  选取2020年7—10月安徽省儿童医院儿童骨科采用闭合复位克氏针内固定术治疗肱骨髁上骨折(Gartland Ⅱ型、Ⅲ型)的86例患儿,采用随机数字表法分为对照组(40例)和观察组(46例)。对照组给予功能锻炼视频指导联合微信平台跟踪的延续护理方法,观察组在对照组的基础上加以专科护士和康复治疗师主导的骨科康复护理门诊管理模式。比较2组患儿术后6个月康复锻炼的依从性、患儿家长满意度、肘关节功能评分(MEPS)、肘关节运动范围评分(ROM)。  结果  观察组与对照组康复锻炼依从性评分为(83.20±13.82)分和(71.00±16.49)分(P<0.001);家长满意度评分为(77.17±20.97)分和(66.25±21.60)分(P=0.020);肘关节MEPS评分为(88.04±8.33)分和(82.50±7.33)分(P=0.002),差异均有统计学意义;肘关节ROM评分在屈曲、伸直、旋前、旋后4个角度评价中观察组均高于对照组(均P<0.05)。  结论  基于骨科康复护理门诊的延续护理管理模式可以促进儿童肱骨髁上骨折术后肘关节功能的康复,提高功能锻炼依从性和患儿家长满意度。 

关 键 词:肱骨髁上骨折   康复护理门诊   延续性护理   儿童骨科   功能锻炼
收稿时间:2021-08-07

Practice and effect of postoperative transitional care of pediatric supracondylar humerus fracture under orthopedic rehabilitation nursing clinic
Affiliation:Department of Orthopaedics, Anhui Provincial Children's Hospital, Hefei, Anhui 230051, China
Abstract:  Objective  To evaluate the intervention effect of transitional care upon orthopedic rehabilitation clinic on the rehabilitation of pediatric supracondylar humerus fracture.  Methods  Between July 2020 and October 2020, 86 cases of pediatric Supracondylar humerus fractures (Gartland Ⅱ/Ⅲ) were selected in Anhui Provincial Children's Hospital from patients who underwent surgery with operated in closed reduction and percutaneous pinning, they were divided into control group (n=40) and observation group (n=46) by using random number table. All the candidates were received the transitional care characterized by video guided functional exercise that combined with Wechat platform tracking, besides, the patients in observation group were under the management of orthopedic nursing rehabilitation clinic with rehabilitation specialist and orthopedic specialist nurse. The compliance of rehabilitation exercise, the satisfaction of the parents, the MEPS (Mayo elbow performance score), and the score of ROM (range of motion) were compared between the two groups.  Results  When comparing between the observation group and the control group, the score of compliance of rehabilitation exercise were (83.20±13.82) points and (71.00±16.49) points, respectively (P < 0.001), the score of parents'satisfaction were (77.17±20.97) points and (66.25±21.60) points, respectively (P=0.020), and the MEPS were (88.04±8.33) points and (82.50±7.33) points, respectively (P=0.002), the referred indicators between the two groups had statistical difference. The ROM scores associated with flexion, extension, pronation and supination of elbow function in the observation group were higher than that of the control group (all P < 0.05).  Conclusion  The transitional care in orthopedic rehabilitation clinic can promote the postoperative rehabilitation of elbow joint of pediatric supracondylar humerus fracture, which improving the rehabilitation training compliance and increasing the satisfaction of the parents. 
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