Application effect of leading health education path in atlantoaxial fracture patient nursing / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of leading health education path on the clinical nursing of patients with atlantoaxial fracture.Methods A retrospective case control study was conducted to analyze 38 patients with atlantoaxial fractures admitted to our hospital from January 2017 to February 2018.There were 31 males and 7 females,aged 21-65 years [(49.6 ± 12.5) years].In the control group,there were 15 males and four females,aged 25-63 years [(48.6 ± 15.3) years].All patients underwent posterior atlantoaxial pedicle screw fixation.Among the patients in control group,there were eight with atlas fracture,four with axial fracture,and seven with atlantoaxial fracture,of which there were five patients of grade C and 14 of grade D according to the American Spinal Injury Association (ASIA)score.There were 16 males and three females,aged 21-62 years [(51.2 ± 12.3) years] in the study group which adopted the leading health education path to provide patients step by step with knowledge of atlantoaxial fracture.In the study group,there were seven patients with atlas fracture,six with axial fracture,and six with atlantoaxial fracture,of which there were seven patients of grade C and 12 patients of grade D based on ASIA.The visual analogue score (VAS) at 1 week and 1 month after operation,Japanese Orthopedic Association (JOA) score at 1 and 6 months after operation,related knowledge mastery,nursing satisfaction,complication incidence,and ASIA grading improvement were compared between the two groups.Results The VAS was (2.1 ± 1.3) points at one week after operation and (1.1 ± 0.6) points at one month after operation in the study group,lower than those of control group [(3.4 ± 2.4) points and (2.1 ± 1.2) points] (P ＜ 0.05).The JOA score of the study group was (15.9 ±1.5) points,higher than that of the control group [(14.7 ± 1.3) points] (P ＜ 0.05).The scores of knowledge mastery including basic knowledge,appropriate medication,complications prevention and functional exercise were (23.2 ± 2.4) points,(24.1 ± 1.7) points,(21.5 ± 3.1) points and (22.8 ±1.6) points respectively in the study group,all of which were higher than those of control group [(14.4 ±3.1)points,(12.9 ±2.1)points,(15.4 ±4.3) points and (13.4 ±3.5)points] (P＜0.05).The satisfaction with nursing in the study group was also higher than that of the control group (P ＜ 0.05).In the study group,one patient (5％) had pulmonary infection,and in the control group nine patients (47％) had complications including two with lower extremity vein embolism,four with urinary tract infection,two with pulmonary infection,and one with pressure injury (P ＜ 0.05).In the study group,there was one patient of grade C,five of grade D and 13 of Grade E according to ASIA;in the control group,there were two of grade C,six of grade D and 11 of Grade E (P ＞ 0.05).Conclusion The leading health education path for patients with atlantoaxial fracture to adopt staged treatment guidance is conducive to relieving pain and improving cervical function,reducing the incidence of complications,and deepening the mastery of relevant knowledge.