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1、 捏脊疗法在下肢骨折住院患者中的应用效果 刘静摘要 目的 研究捏脊疗法对下肢骨折患者住院期间并发症和负面情绪的影响。 方法 选择2015年5月2017年5月在聊城市中医医院住院的下肢骨折患者94例作为研究对象,按照随机数表法将其分为实验组和对照组,每组各47例。对照组采用常规护理措施,实验组在常规组基础上采用捏脊疗法进行护理。采用由Thomas等编制的纽卡斯尔护理满意度量表对患者的护理满意度进行评价,比较两组腹胀、便秘、尿潴留治疗效果,采用焦虑自评量表、抑郁自评量表对干预前后两组患者的焦虑、抑郁程度进行评估。 结果 实验组总满意度显著高于对照组,差异有统计学意义(P 0.05)。实验组患者腹胀
2、、便秘和尿潴留总有效率均高于对照组,差异均有统计学意义(P 0.05)。干预后实验组焦虑、抑郁评分均低于对照组,差异均有统计学意义(P 0.05)。 结论 捏脊疗法可以有效改善患者的负面情绪和术后卧床期间的腹胀、便秘和尿潴留,值得临床推广应用。关键字 捏脊疗法;下肢骨折;腹胀;便秘;负面情绪 R473.6 A 1673-7210(2018)06(b)-0151-04Abstract Objective To study the effect of chiropractic therapy on complications and negative emotions of patients wi
3、th lower extremity fracture during hospitalization. Methods A total of 94 patients with lower extremity fractures in Liaocheng Traditional Chinese Medicine Hospital from May 2015 to May 2017 were selected as the research objects and divided into the experimental group and the control group according
4、 to the random number table, with 47 cases in each group. The control group was given routine nursing care and the experimental group was given chiropractic therapy on the basis of routine group. The nursing satisfaction of the patients was evaluated by the Newcastle care satisfaction scale compiled
5、 by Thomas et al. The treatment efficacy of bloating, constipation and urinary retention were compared between the two groups. Self-rating anxiety scale and self-rating depression scale were applied to evaluate the degree of anxiety and depression before and after intervention. Results The total sat
6、isfaction rate in the experimental group was higher than that of control group, with statistically significant difference (P 0.05). The total effective rate of abdominal distension, constipation and urinary retention in the experimental group were all higher than those of control group, with statist
7、ically significant differences (P 0.05). After intervention, the scores of anxiety and depression in the experimental group were all lower than those of control group, with statistically significant differences (P 80分为满意,6080分为比较满意,60分为不满意。总满意度=(满意+比较满意)例数/总例数100%。1.4.2 腹胀、便秘、尿潴留治疗效果评价 腹胀:患者术后16 h排气
8、记为无效。便秘:术后患者12 d内排便通畅且未出现腹部胀痛或者出现后消失记为显效,34 d首次排除大便但仍欠通畅,且伴有轻微腹部胀痛记为有效,患者5 d以后仍存在腹部胀痛且无排便现象记为无效。尿潴留:患者术后可以自行排尿记为显效,患者可以自行排尿但膀胱内存有余尿记为有效,患者无法自行排尿需导尿装置帮助记为无效。总有效率=(显效+有效)例数/总例数100%1.4.3 负面情绪评价 分别在干预前(手术后1 d)和干预后(手术后2周)采用焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评估两组
9、患者的焦虑抑郁程度,SAS、SDS评分与焦虑抑郁程度成正比,即评分越高,抑郁或焦虑越严重9。1.4 统计学方法采用SPSS 17.0对所得数据进行统计学分析,计量资料采用均数标准差(xs)表示,组间比较采用t检验,计数资料采用百分率表示,组间比较采用2检验。以P 0.05为差异有统计学意义。2 结果2.1 两组护理满意度比较实验组总体满意度明显高于对照组,差异有统计学意义(P 0.05)。见表1。2.2 两组腹胀、便秘、尿潴留治疗效果比较实验组腹胀、便秘、尿潴留总有效率均明显高于对照组,差异均有统计学意义(P 0.05)。干预后两组SAS、SDS得分均低于干预前,实验组明显低于对照组,差异均有统计学意义(P 0.05)。见表3。3 讨论骨外伤,尤其是下肢骨折,往往需要夹板或者石膏固定恢复,严重者更是要进行手术固定,患者也因此需要长时间的卧床休息来观察恢复效果10。在长时间的卧床过程中患者因为术后饮食问题,卧床时间过长导致的肠胃蠕动缓慢和水分过度吸收,受