骨折联络服务在老年髋部脆性骨折患者中的应用

doi:10.3761/j.issn.0254-1769.2019.09.012

中华护理杂志 ›› 2019, Vol. 54 ›› Issue (9): 1343-1348.DOI: 10.3761/j.issn.0254-1769.2019.09.012

骨折联络服务在老年髋部脆性骨折患者中的应用

刘春香,成传芳,赵晨,翟洁婷,刘春兰,段功香()

421001 湖南省衡阳市南华大学护理学院（刘春香，成传芳，赵晨，段功香）；南华大学附属第二医院创伤骨科（翟洁婷，刘春兰）

收稿日期:2019-04-18 出版日期:2019-09-15 发布日期:2019-09-19
通讯作者: 段功香
作者简介:刘春香：女，硕士，护士，E-mail：798312839@qq.com
基金资助:
2018年南华大学研究生科学基金项目(2018KYY298)

The intervention effects of fracture liaison service in elderly patients with hip fragility fractures

LIU Chunxiang,CHENG Chuanfang,ZHAO Chen,ZHAI Jieting,LIU Chunlan,DUAN Gongxiang()

Received:2019-04-18 Online:2019-09-15 Published:2019-09-19
Contact: Gongxiang DUAN

摘要/Abstract

摘要：

目的探讨骨折联络服务在老年髋部脆性骨折患者中的应用效果。方法选取2018年3月—7月某三级甲等医院老年髋部脆性骨折患者106例,根据患者入院顺序依次编号,采用奇偶数字抓阄法,编号为奇数者纳入试验组（n=53）,编号为偶数者纳入对照组（n=53）。试验组在常规护理基础上实施骨折联络服务,对照组实施常规护理。使用老年人衰弱评估量表比较两组衰弱程度、骨质疏松确诊情况和二次骨折发生情况。结果干预3个月后,试验组患者老年人衰弱评估量表的生理及心理衰弱维度得分低于对照组;干预6个月后,试验组生理、心理、认知维度得分及总分低于对照组,差异均有统计学意义（P<0.05）。重复测量方差分析结果显示,两组生理、认知维度得分及总分的组间效应、时间效应以及两者交互作用均有统计学意义（P<0.05）。干预3个月及6个月后,试验组骨质疏松确诊率均高于对照组,差异有统计学意义（P<0.05）。不同干预时期,两组二次骨折发生情况比较,差异无统计学意义（P>0.05）。结论骨折联络服务可降低老年髋部脆性骨折患者的衰弱程度,提高患者的骨质疏松确诊率。

关键词: 髋骨折, 老年人, 护理评估, 健康教育, 护理实践模式, 矫形外科护理

Abstract:

Objective To explore the intervention effects of fracture liaison service in elderly patients with hip fragility fractures.Methods Totally 106 patients with hip fragility fractures were selected in a tertiary hospital from March to July 2018. The patients were numbered according to the admission order. The odd-numbered digital grasping method was used to determine that patients with the odd numbers were included in the experimental group（n=53）,and those with even numbers were included in the control group（n=53）. The experimental group was given fracture liaison service on the basis of routine nursing and the control group was given routine nursing. The degree of frailty（Elderly Frailty Assessment Scale）,osteoporosis diagnosis rate and secondary fracture incidence were compared between two groups.Results After 3 months of intervention,the scores of physiological and psychological frailty dimensions in the experimental group were lower than those in the control group. After 6 months of intervention,the scores of physiological,psychological,cognitive dimensions and frailty total score in the experimental group were lower than those in the control group,and the differences were statistically significant（P<0.05）. Repeated measurement analysis of variance results showed that the inter-group effect,time effect and interaction between the two groups of physiological,cognitive dimension score and frailty total score were statistically significant（P<0.05）. After 3 months and 6 months of intervention,the diagnosis rate of osteoporosis in the experimental group was higher than that in the control group,and the difference was statistically significant（P<0.05）. There was no significant difference in the incidence of secondary fracture between two groups during different intervention periods（P>0.05）.Conclusion Fracture liaison service can reduce the degree of frailty in elderly patients with hip fragility fractures,and improve the patients’ osteoporosis diagnosis rate.

Key words: Hip Fractures, Aged, Nursing Assessment, Health Education, Nurse’s Practice Patterns, Orthopedic Nursing

刘春香, 成传芳, 赵晨, 翟洁婷, 刘春兰, 段功香. 骨折联络服务在老年髋部脆性骨折患者中的应用[J]. 中华护理杂志, 2019, 54(9): 1343-1348.

LIU Chunxiang, CHENG Chuanfang, ZHAO Chen, ZHAI Jieting, LIU Chunlan, DUAN Gongxiang. The intervention effects of fracture liaison service in elderly patients with hip fragility fractures[J]. Chinese Journal of Nursing, 2019, 54(9): 1343-1348.

参考文献 19

[1]	中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松诊疗指南(2017)[J]. 中华骨质疏松和骨矿盐疾病杂志, 2017,10(5):413-444.
[2]	殷兵, 郭家良, 董天华 , 等. 西南地区11家医院成人髋部骨折患者临床特征构成分析[J]. 中华外科杂志, 2015,53(5):349-352.
[3]	Greenspan SL, Wyman A, Hooven FH , et al. Predictors of treatment with osteoporosis medications after recent fragility fractures in a multinational cohort of postmenopausal women[J]. J Am Geriatr Soc, 2012,60(3):455-461.
[4]	戴静, 尚芬兰, 葛晓琴 , 等. 二次髋部骨折相关因素研究进展[J]. 中国骨质疏松杂志, 2017,23(5):676-682.
[5]	卢雯, 陈丽萍 . 高龄骨折患者出院后医院与社区护理有效衔接的效果评价[J]. 中华护理杂志, 2015,50(3):280-283.
[6]	Akesson K, Marsh D, Mitchell PJ , et al. Capture the Fracture:a Best Practice Framework and global campaign to break the fragility fracture cycle[J]. Osteoporos Int, 2013,24(8):2135-2152.
[7]	肖恩, 邓忠良, 李毅中 , 等. 骨质疏松骨折二级预防之骨折联络员模式探讨华南/华西区骨科专家研讨会议纪要[J]. 中华关节外科杂志(电子版), 2015,9(5):673-675.
[8]	邱贵兴, 裴福兴, 胡侦明 , 等. 中国骨质疏松性骨折诊疗指南(全文)(骨质疏松性骨折诊断及治疗原则)[J]. 中华关节外科杂志(电子版), 2015,9(6):795-798.
[9]	莫少媛, 阮柳红 . 中医分期饮食护理对股骨粗隆间骨折患者的效果观察[J]. 中国医药指南, 2013,11(14):370-371.
[10]	葛向煜, 王君俏, 刘邦忠 , 等. 老年髋部骨折患者术后肢体功能恢复的康复护理研究进展[J]. 中华护理杂志, 2008,43(6):550-553.
[11]	The Joanna Briggs Institute. 住院老年患者跌倒预防[J]. 中华护理杂志, 2013,48(6):574-576.
[12]	李菲, 刘慧松, 查龙肖 , 等. 中文版老年人衰弱评估量表的修订和信效度评价[J]. 护理学杂志, 2017,32(7):18-20,27.
[13]	王钰, 彭静娴, 程晓光 , 等. DXA与QCT预测骨折风险的进展:非骨密度测量指标[J]. 中国骨质疏松杂志, 2018,24(5):561-566.
[14]	Kung AW, Fan T, Xu L , et al. Factors influencing diagnosis and treatment of osteoporosis after a fragility fracture among postmenopausal women in Asian countries:a retrospective study[J]. BMC Womens Health, 2013,13:7.
[15]	Sobolev B, Sheehan KJ, Kuramoto L , et al. Excess mortality associated with second hip fracture[J]. Osteoporos Int, 2015,26(7):1903-1910.
[16]	刘朝露 . FLS模式在OVCF患者中的应用研究[D]. 遵义:遵义医学院, 2018.
[17]	Hawley S, Javaid MK, Prieto-Alhambra D , et al. Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients:population-based longitudinal study[J]. Age Ageing, 2016,45(2):236-242.
[18]	Nakayama A, Major G, Holliday E , et al. Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate[J]. Osteoporos Int, 2016,27(3):873-879.
[19]	Axelsson KF, Jacobsson R, Lund D , et al. Effectiveness of a minimal resource fracture liaison service[J]. Osteoporos Int, 2016,27(11):3165-3175.

骨折联络服务在老年髋部脆性骨折患者中的应用

The intervention effects of fracture liaison service in elderly patients with hip fragility fractures

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