探究采用协作护理干预对老年髋部骨折患者术后日常生活能力、髋关节功能的影响。 方法:选择我院2020年2月-2021年2月进行髋部骨折手术治疗的78例老年患者作为研究对象,利用摸球法将患者分成观察组( n=39 )和对照组(n=39),对照组采用骨科手术常规护理,观察组采用常规护理与协作护理。比较2组治疗前、后1周的焦虑自评量表(SAS)、抑郁自评量表( SDS)、髋关节功能( Harris)、日常生活能力( Barthel)评分,观察2组患者干预后的依从性和术后并发症情况。结果:观察组干预后1 周的SAS、SDS评分均低于对照组( P<0. 05 );观察组治疗后1 周的Harris、Barthel评分均高于对照组( P<0. 05);观察组干预后的依从性高于对照组(P<0. 05);观察组干预后的并发症总发生率低于对照组(P>0. 05)。结论:对老年髋部骨折患者采用协作护理可改善其不良情绪和髋关节功能,依从性得以提升,术后并发症风险降低,提高患者的日常生活能力。

Recently, tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) have been applied in total hip arthroplasty (THA). However, doubts in clinicians’ minds about which medicine is more efficient and economical in THA need to be clarified. Therefore, this study compared the efficacy and cost of the intraoperative administration of TXA and EACA per surgery in decreasing perioperative blood transfusion rates in THA. This study enrolled patients who underwent THA between January 2019 to December 2020. A total of 295 patients were retrospectively divided to receive topical combined with intravenous TXA (n = 94), EACA (n = 97) or control (n = 104). The primary endpoints included transfusions, estimated perioperative blood loss, cost per patient and the drop in the haemoglobin and haematocrit levels. Patients who received EACA had greater total blood loss, blood transfusion rates, changes in HGB levels and mean cost of blood transfusion per patient (P < 0.05) compared with patients who received TXA. In addition, both TXA and EACA groups had significantly fewer perioperative blood loss, blood transfusion, operation time and changes in haemoglobin and haematocrit levels than the control group (P < 0.05). Cost savings in the TXA and EACA groups were 736.00 RMB and 408.00 RMB per patient, respectively. The application of perioperative antifibrinolytics notably reduces the need for perioperative blood transfusions. What’s more, this study demonstrated that TXA is superior to EACA for decreasing blood loss and transfusion rates while at a lower cost per surgery. These results indicate that TXA may be the optimum antifibrinolytics for THA in Chinese area rather than EACA.

Zinc (Zn2+) Nanoparticles have been widely employed for biomedical submissions. Still, its part in the osteogenic distinction of mouse primary (M-prim) bone-marrow-stromal cells (BMSCs) is not completely understood. The transientreceptor-potential melastatin 7 (TRPM7) shares the unique feature of channel permeability to Zn2+. The current study was designed to evaluate the outcome of Zn2+ on adipogenic and osteogenic (Os and Ad) variation of BMSCs via the TRPM7 pathway. Dexamethasone plays a vital part in regularizing insulin sensitization and adipose tissue (AT) distribution. A series of experimental methods, CCK-8 assays, wound-scratched assay, proliferation studies, and cells migration assays were used to assess the impact of Zn2+ on the Os and Ad variation (Os and Ad-Dif) of M-prim BMSCs. The outcomes showed that excluding distinct concentration of Zn2+ there were no impressions on osteoblasts and MSCs proliferation. The differentiation, rate of apoptosis and wound area were as insignificant compared with negative control upon employing siTRPM7 with individual Zn2+. The data suggested that Zn2+ protecting or shielding effects on bone are possibly mediated via modulating variation of BMSCs away from adipocytes via TRPM7 signalling pathway. These outcomes may be helpful for well elaborating the mechanism of Zn2+ effects on bone.

目的 探讨谵妄评估表在老年髋关节置换围手术期护理中的应用效果.方法 研究时间截取2020年7月-2021年7月,研究对象为我院收治的行髋关节置换术的老年患者126例,将患者按照数字表随机排序法分为两组各63例,即接受护理谵妄评估表(Nu-DESC)+常规护理的对照组与接受重症监护谵妄筛查表(ICDSC)+围手术期综合护理的观察组.通过对两组术后认知功能检查量表(MMSE)、谵妄发生率、平均住院时间、髋关节功能评估量表(Harris)及护理满意度调查结果评价护理效果.结果 观察组在术后3d、5d的MMSE评