预防性护理干预对骨折患者脂肪栓塞发生率及预后的影响研究_骨折引起脂肪栓塞是由于

　　【摘要】 目的 探讨早期预防性护理干预对骨折后脂肪栓塞发生率及预后的影响。方法 选取我院4年内900例骨折患者，随机分为两组，其中A组450例，B组450例，A组给予常规护理，共出现脂肪栓塞59例归入a组，B组给予预防性护理干预，共出现脂肪栓塞32例归入b组。对a组患者进行常规护理，对b组患者进行综合护理干预。对两组患者治疗前后血氧浓度(SPO2)、氧分压(PaO2)、血红蛋白(Hb)、血小板和心率(HR)进行监测并统计。结果 A组脂肪栓塞发生率为13.11%，B组脂肪栓塞发生率为7.11%，两组差异有统计学意义(P0.05)。结论 对于骨科手术并发脂肪栓塞应给予积极的预防护理，减少严重不良后果的发生；一旦发生脂肪栓塞，应进行积极治疗。
　　【关键词】 骨科；手术；脂肪栓塞综合征；护理
　　Preventive Care Intervention on Fat Embolism After the Fracture About Occurred Rate and Prognosis WANG Ning. Orthopedics in Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine (Jinan 250001)
　　【Abstract】 Objective To investigate the preventive care intervention on fat embolism after the fracture about occurred rate and prognosis. Methods 900 cases of fracture patients were randomly divided into two groups, group A and group B,450 cases in each group, A group received conventional care, there were 59 cases of fat embolism who were classified as a group, Group B received preventive care interventions, there were 32 cases of fat embolism who were classified in group b. Give routine care to group a and give comprehensive nursing intervention for patients in group b.The Oxygen concentration (SPO2,), the partial pressure of oxygen (PaO2), hemoglobin (Hb), platelets and heart rate (HR) in the two groups of patients before and after treatment were taken for monitoring and statistics. Results Fat embolism incidence rate in Group A fat was 13.11%, and 7.11% in Group B, two groups have significant difference (P 0.05). Conclusion Proactive and preventive care should be given to orthopedic surgery patients in order to reduce the incidence of serious adverse consequences. Active treatment should be carried out to reduce the event of fat embolism.
　　【Key words】 orthopedics; surgery; fat embolism syndrome; care
　　
　　脂肪栓塞综合征是指人体受到严重创伤、骨折或在骨科手术后，出现以呼吸困难、进行性低氧血症、意识障碍、皮肤黏膜出血为主要特征的症候群［1］。此综合征好发于长骨骨折，尤其是多段股骨干骨折和骨折行髓内针固定术后，也可发生于行人工关节置换术后。各类骨折后发生本病的死亡率平均为16.3%，如果股骨干骨折合并多发骨折或休克，死亡率会上升至50%～60%［2］。脂肪栓塞综合征是威胁患者生命的骨科严重并发症之一，对于具有好发病因和部位的创伤，需高度警惕，做到早期诊断、及时救治、降低死亡率［3］。本研究通过回顾分析2008年6月至2012年6月期间我院收治的900例骨科手术患者，因骨科手术并发脂肪栓塞综合征的患者共91临床资料，现报告如下。