摘要
目的 观察老年骨科手术期间构建综合中医理念介入的风险控制管理方案的临床实施效果.方法 将130 例老年骨科手术患者按照随机数字表法分为2 组,对照组65 例予以常规手术室风险控制管理,观察组65 例在对照组基础上予以综合中医理念介入的风险控制管理方案,2 组均自入院干预至手术结束.比较2 组术中出血量、术后疼痛视觉模拟评分(VAS)、术后下床时间及住院时间、手术相关并发症发生率、炎症指标[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)及C反应蛋白(CRP)]及血液流变学指标[全血还原黏度、全血黏度(高切)、全血黏度(中切)、全血黏度(低切)及红细胞沉降率(ESR)]水平差异.结果 观察组术中出血量、术后疼痛VAS均低于对照组(P<0.05),首次下床时间及总住院时间均短于对照组(P<0.05).观察组手术相关并发症发生率低于对照组(P<0.05).2 组术后 3 天血清IL-6、TNF-α水平均较本组治疗前升高(P<0.05),CRP水平均降低(P<0.05);观察组术后 3 天血清IL-6、TNF-α、CRP水平均低于对照组同期(P<0.05).2 组术后 3 天全血还原黏度、全血黏度(高切)、全血黏度(中切)、全血黏度(低切)及ESR均较本组术前降低(P<0.05),观察组术后3 天均低于对照组同期(P<0.05).观察组干预满意度评分高于对照组(P<0.05).结论 在老年骨科手术患者中应用综合中医理念介入的风险控制管理方案能够改善患者术后一般情况,降低并发症风险与炎症反应程度,改善血液流变学指标,患者满意度良好.
Abstract
Objective To observe the clinical effect of traditional Chinese medicine(TCM)comprehensive intervention by constructing a risk control management plan in orthopedic surgery elderly.Methods A total of 130 elderly orthopedic surgery patients were randomly assigned to the control group(n=65)or the observation group(n=65).All patients received routine risk control management,those in the observation group additionally received TCM comprehensive intervention by constructing a risk control management plan.Both groups received intervention from admission to the end of the surgery.The intraoperative bleeding volume,postoperative pain symptoms,postoperative time to get out of bed and hospital stay,visual analogue scale(VAS)for postoperative pain,surgical-related complication rate,inflammatory indicators(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],C-reactive protein[CRP]),hemorheological indicators(whole blood reduced viscosity,whole blood viscosity(high shear,medium shear,low shear)and erythrocyte sedimentation rate[ESR])were included as comparators between the two groups.Results The intraoperative bleeding volume and VAS for postoperative pain score in the observation group were significantly lower than those of the control group(P<0.05),and the first time of getting out of bed and total hospi-tal stay were significantly shorter than those of the control group(P<0.05).The incidence of surgery-related complications in the observation group was significantly lower than that of the control group(P<0.05).The levels of serum IL-6,TNF-α and CRP in the two groups on the day 3 of postoperation were significantly lower than those before operation(P<0.05),and which were significantly lower in the observation group compared to the control group(P<0.05).The levels of whole blood reduction viscosity,whole blood viscosity(high shear,middle shear,low shear)and ESR in the two groups were significantly lower than those of before operation(P<0.05),which were significantly lower in the observation group relative to the control group(P<0.05).The intervention satisfaction score in the observation group was significantly higher than that of the control group(P<0.05).Conclusion The application of TCM comprehensive intervention by constructing a risk control management plan in orthopedic surgery elderly can improve their general postoperative situation,reduce the risk of complications and inflammatory reaction,improve hemorheological indicators,and achieve good pa-tient satisfaction.
国家科技期刊平台
NSTL
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