目的 探究基于Caprini风险评估的分级护理在髋关节置换术患者下肢深静脉血栓（DVT）形成中的预防作用。方法 选取2022年4月至2024年10月在南阳市第二人民医院行髋关节置换术患者74例，根据护理方案不同分为常规组和Caprini分级组，各37例。常规组开展常规护理干预，Caprini分级组在常规护理基础上开展基于Caprini风险评估的分级护理。比较两组干预前后凝血功能指标[凝血酶原时间（PT）、凝血酶时间（TT）、活化部分的凝血活酶时间（APTT）]、患肢血流速度、髋关节功能[髋关节指数（HSS）]、自护能力[自护能力测量量表（ESCA）]；比较两组术后DVT发生率及护理满意度。结果 术后24 h，Caprini分级组凝血功能指标PT、TT、APTT均高于常规组（P＜0.05）；出院时，Caprini分级组患肢髂静脉、股静脉、腘静脉血流速度均高于常规组（P＜0.05）；出院时、术后3个月，Caprini分级组髋关节功能各指标评分、自护能力各指标评分、护理满意度各指标评分均高于常规组（P＜0.05）；术后3个月，Caprini分级组DVT总发生率低于常规组（P＜0.05）。结论 基于Caprini风险评估的分级护理可有效减轻髋关节置换术患者凝血功能异常，提升患肢各处静脉血流速度，降低DVT发生率，改善其髋关节功能，提高自护能力与护理满意度。

目的 探讨全身麻醉（全麻）髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为（56.35±5.86）分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室（AICU）住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素（P<0.05）。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。

Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia．Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected．The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated．The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed．Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was（56.35±5.86）,with a moderate level．Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia（P<0.05）．Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles．

目的 研究全髋关节置换术对于股骨颈骨折老年患者的适用性。方法 回顾性分析本院2012年1月—2014年1月间收治的89例股骨颈骨折老年患者,根据不同治疗术式将患者分为两组,将其中采取人工全髋关节置换术治疗的56例患者纳入全髋组,以将其中采取半髋关节置换术治疗的33例患者纳入半髋组,对比两组患者的手术情况,随访一年评估疗效并统计功能恢复时间以及并发症发生情况。结果 半髋组各项手术情况观察指标均优于全髋组,P<0.05;治疗后随访一年,全髋组总有效为96.43%,半髋组总有效率为93.94%,全髋组疗效优于对照组,P<0.05;全髋组并发症发生率为3.57%,半髋组并发症发生率为18.18%,全髋组并发症发生率优于半髋组,P<0.01。结论 全髋关节置换术治疗股骨颈骨折老年患者适用性高于半髋关节置换术,可考虑作为老年患者的首选术式加以推广。

Objective To study the applicability of total hip arthroplasty in elderly patients with femoral neck fracture. Methods A retrospective analysis of 89 cases of elderly patients with femoral neck fracture in our hospital was made from January 2012 to January 2014, according to different surgical methods. The patients were divided into two groups, among them 56 cases of total hip arthroplasty were in the total hip group, and 33 cases of hip replacement were in the semi hip arthroplasty group. To compare the surgery condition, one year of follow-up evaluation of occurrence curative effect was made and added up the function recovery time and complications in the two groups. Results The surgical observation indicators in the semi arthroplasty group were better than the total hip group, P<0.05; follow-up one year after the treatment, the total effective rate of the total hip group was 96.43%, that in the semi hip arthroplasty group was 93.94%, thus the curative effect of the total hip group was better than the control group, P<0.05; The incidence of complications of the total hip arthroplasty group was 3.57%, that in the semi hip arthroplasty group was 18.18%, thus the incidence of complications of the total hip group was better than the semi hip group, P<0.01. Conclusion The adaptability of the total hip arthroplasty in the treatment of elderly patients with femoral neck fractures is better than the semi hip replacement surgery, and it may be considered as the first choice for the elderly patients to promote.

目的 观察康复路径在髋关节置换术后的临床应用效果,探讨其临床应用价值 。方法 将广州市第一人民医院2014年10月—2015年10月收治行髋关节置换术患者100例为研究对象,随机分为对照组与观察组各50例。对照组采取常规围手术期护理,观察组按照康复路径护理,比较两组患者术后并发症、住院时间、费用、患肢功能以及日常生活自理能力。结果 观察组住院时间和住院费用均少于对照组(P<0.01);两组术后并发症发生率、患肢功能评分及日常生活自理能力比较,差异均有统计学意义(P<0.01 )。结论 康复计划护理用于髋关节置换术后效果显著,可明显降低患者术后并发症,缩短住院时间,降低住院费用,有利于促进患者术后功能以及自理能力的恢复。

Objective To observe the effect of clinical application of rehabilitation in the path of a hip replacement, and to explore its clinical application value. Methods October 2014 to October 2015 in Guangzhou First People's Hospitalhip arthroplasty cases werecollected of 100 patients as the research object, randomly divided into control group and observation group with 50 cases in each group. The control group adopted conventional perioperation period nursing care, observation group in accordance with the recovery paths. We compared two groups of patients complications, hospitalization time, expense, limb function and activities of daily living. Results In the observation group, the hospitalization time and cost of hospitalization were significantly less than that of the control group (P<0.01); The incidence of limb function score, ability of daily living and postoperative complications were compared between the two groups, the differences were statistically significant (P<0.01). Conclusion Rehabilitation nursing care plans for after hip replacement effect is significant. It can significantly reduce the postoperative complications, shorten the time of hospitalization, reduce hospitalization expenses, and is beneficial to the recovery of the function of promoting postoperative and self-care ability.

       目的   对比分析双极半髋关节置换术（BHA）与全髋关节置换术（THR）治疗股骨颈骨折（FNF）的效果。方法   回顾性收集北京中医药大学东直门医院洛阳医院2019年6月—2023年4月90例FNF患者临床资料，依照手术治疗方案差异分为两组，BHA组（45例）行BHA治疗，THR组（45例）行THR治疗，比较两组围术期指标、术前及术后3 d炎症因子水平、术后6个月髋关节活动度、术前及术后6个月生活质量［欧洲生活质量评分（EQ-5D评分）］。结果  THR组手术时间（108.76±15.33）min、下床活动时间（40.37±10.24）h、住院时间（19.02±5.11）d均较BHA组［（53.49±10.12）min、（25.92±7.15）h、（15.16±4.87）d］长（t分别为20.184、7.761、3.668，均P＜0.05），术中失血量（318.69±35.14）mL、术后引流量（129.74±21.03）mL均较BHA组［（224.07±29.35）mL、（90.35±17.48）mL］多（t分别为13.863、9.663，均P＜0.001）；组间并发症发生率比较差异无统计学意义（P＞0.05）；术后3 d，BHA组血清白细胞介素-1为（17.35±3.06）pg/L、白细胞介素-6为（24.82±4.31）pg/L、C-反应蛋白为（26.17±4.59）pg/L，低于THR组的（20.16±3.48）pg/L、（27.04±5.06）pg/L、（28.90±5.12）pg/L（t分别为4.068、2.241、2.663，均P＜0.05）；两组术后6个月髋关节内旋、屈曲、外旋、外展、内收活动度及EQ-5D评分对比差异均无统计学意义（均P＞0.05）。结论   与THR相比，BHA能减少FNF患者围术期失血量，降低术后炎症因子表达水平，缩短手术及下床活动时间，促进恢复。

      Objective  To compare and analyze the effects of bipolar hemihip replacement（BHA）and total  hip replacement（THR）in the treatment of femoral neck fracture（FNF）．Methods  The clinical data of 90 patients with FNF in the Luoyang Hospital，Dongzhimen Hospital，Beijing University of Chinese Medicine，from June 2019 to April 2023 were retrospectively collected．The patients were divided into two groups according to the difference in surgical treatment plan．The BHA group（45 cases）received BHA treatment，and the THR group（45 cases）received THR treatment．The perioperative indicators，preoperative and postoperative inflammatory factor levels，postoperative hip joint mobility at six months，preoperative and postoperative quality of life ［European Quality of Life Scale（EQ-5D score）］were compared between the two groups．Results  The operation time（108.76±15.33）min，ambulation time（40.37±10.24）h，and hospitalization time（19.02±5.11）d in the  THR  group were longer than those in the BHA group ［（53.49±10.12）min，（25.92±7.15）h，（15.16±4.87）d］（t=20.184，8.630，3.668，respectively，all P＜0.05）．The intraoperative blood loss（318.69±35.14）mL and  postoperative  drainage volume（129.74±21.03）mL were both higher than those in the BHA group ［（224.07±29.35）mL，（90.35±17.48）mL］（t=13.863，9.663，respectively，all P＜0.001）．There was no significant difference in the incidence of complications between the groups（P＞0.05）．Three days after surgery，the serum levels of interleukin-1，interleukin-6，and C-reactive protein in the BHA group were（17.35±3.06）pg/L，（24.82±4.31）pg/L，and（26.17±4.59）pg/L，respectively，which were lower than those in the THR group（20.16±3.48）pg/L，（27.04±5.06）pg/L，and（28.90±5.12）pg/L（t=4.068，2.241，2.663，respectively，all P＜0.05）．There was no significant difference in the range of motion of internal rotation，flexion，external rotation，abduction，and adduction of the hip joint and EQ-5D scores between the two groups at six months after surgery（all P＞0.05）．Conclusions  Compared with THR，BHA can reduce perioperative blood loss in FNF patients，reduce postoperative inflammatory factor expression level，shorten operation and ambulation time，and promote recovery．