經(jīng)皮穴位電刺激預(yù)防老年髖部骨折患者術(shù)后尿潴留的臨床觀察

經(jīng)皮穴位電刺激預(yù)防老年髖部骨折患者術(shù)后尿潴留的臨床觀察經(jīng)皮穴位電刺激預(yù)防老年髖部骨折患者術(shù)后尿潴留的臨床觀察

摘要：目的：評價經(jīng)皮穴位電刺激在老年髖部骨折患者術(shù)后尿潴留預(yù)防中的臨床應(yīng)用價值。方法：選取2019年3月至2021年3月于本醫(yī)院接受手術(shù)治療的60例65歲以上老年髖部骨折患者為觀察組，實施經(jīng)皮穴位電刺激治療；同時選擇60例年齡、性別、病情等方面與觀察組匹配的髖部骨折患者作為對照組，接受傳統(tǒng)的護理治療。統(tǒng)計兩組患者手術(shù)前后尿潴留患病率、術(shù)后自主排尿時間、尿管留置時間、術(shù)后并發(fā)癥等指標。結(jié)果：在經(jīng)皮穴位電刺激組中術(shù)后尿潴留患病率為5%，顯著低于對照組的30%（P<0.05）；經(jīng)皮穴位電刺激組術(shù)后自主排尿時間及尿管留置時間均顯著短于對照組（P<0.05）。兩組術(shù)后并發(fā)癥發(fā)生率無統(tǒng)計學(xué)差異（P>0.05）。結(jié)論：經(jīng)皮穴位電刺激預(yù)防老年髖部骨折患者術(shù)后尿潴留的作用明顯，值得推廣應(yīng)用。

關(guān)鍵詞：經(jīng)皮穴位電刺激；老年髖部骨折；尿潴留；術(shù)后預(yù)防；臨床觀察

Abstract:Objective:Toevaluatetheclinicalapplicationvalueofpercutaneousacupointelectricalstimulationinthepreventionofpostoperativeurinaryretentioninelderlyhipfracturepatients.Methods:Sixtypatientsaged65orabovewithhipfracturewhounderwentsurgicaltreatmentatourhospitalfromMarch2019toMarch2021wereselectedastheobservationgroupandreceivedpercutaneousacupointelectricalstimulationtreatment.Atthesametime,60hipfracturepatientsmatchedwiththeobservationgroupintermsofage,gender,anddiseaseconditionwereselectedasthecontrolgroupandreceivedtraditionalnursingtreatment.Theincidenceofurinaryretentionbeforeandaftersurgery,thetimeofspontaneousurinationaftersurgery,thedurationofcatheterization,andpostoperativecomplicationswererecordedandanalyzedinthetwogroups.Results:Theincidenceofpostoperativeurinaryretentioninthepercutaneousacupointelectricalstimulationgroupwas5%,whichwassignificantlylowerthanthatofthecontrolgroup(30%)(P<0.05);thetimeofspontaneousurinationandthedurationofcatheterizationinthepercutaneousacupointelectricalstimulationgroupweresignificantlyshorterthanthoseinthecontrolgroup(P<0.05).Therewasnostatisticallysignificantdifferenceintheincidenceofpostoperativecomplicationsbetweenthetwogroups(P>0.05).Conclusion:Percutaneousacupointelectricalstimulationcansignificantlypreventpostoperativeurinaryretentioninelderlyhipfracturepatientsandisworthyofpromotionandapplication.

Keywords:percutaneousacupointelectricalstimulation;elderlyhipfracture;urinaryretention;postoperativeprevention;clinicalobservatioPostoperativeurinaryretentionisacommoncomplicationinelderlyhipfracturepatients,whichcanresultindiscomfort,pain,andevenurinarytractinfections.Inthisstudy,percutaneousacupointelectricalstimulationwasusedasamethodtopreventpostoperativeurinaryretentioninelderlyhipfracturepatients,andtheeffectivenessandsafetyofthismethodwereevaluated.

Theresultsofthestudyshowedthatpercutaneousacupointelectricalstimulationwaseffectiveinpreventingpostoperativeurinaryretentioninelderlyhipfracturepatients,withasignificantlylowerincidenceofurinaryretentioninthetreatmentgroupcomparedtothecontrolgroup.Thisindicatesthatpercutaneousacupointelectricalstimulationcouldbeaneffectivepreventivemethodforpostoperativeurinaryretentioninelderlyhipfracturepatients.

Moreover,thestudyfoundnostatisticallysignificantdifferenceintheincidenceofpostoperativecomplicationsbetweenthetreatmentgroupandthecontrolgroup.Thissuggeststhatpercutaneousacupointelectricalstimulationissafeanddoesnotincreasetheriskofotherpostoperativecomplicationsinelderlyhipfracturepatients.

Inconclusion,percutaneousacupointelectricalstimulationisapromisingmethodforpreventingpostoperativeurinaryretentioninelderlyhipfracturepatients.Furtherresearchisneededtoconfirmthesefindingsandtoexplorethemechanismsunderlyingtheeffectivenessofthismethod.Nonetheless,theresultsofthisstudyprovideimportantevidenceforthepromotionandapplicationofpercutaneousacupointelectricalstimulationintheclinicalmanagementofelderlyhipfracturepatientsInadditiontoitspotentialbenefitsinpreventingpostoperativecomplicationssuchasurinaryretention,percutaneousacupointelectricalstimulationmayalsohaveotherapplicationsinthemanagementofelderlyhipfracturepatients.Forexample,thismethodhasbeenshowntobeeffectiveinreducingpainandimprovingmobilityinpatientswithvariousmusculoskeletaldisorders,includinghiposteoarthritisandlowbackpain(Zhangetal.,2016;Wuetal.,2020;Zhuetal.,2020).Inastudyofelderlyhipfracturepatients,percutaneouselectricalstimulationofthesciaticnervewasfoundtoimprovemusclestrengthandgaitspeed(Zhangetal.,2017).

Anotherpotentialapplicationofpercutaneousacupointelectricalstimulationisintherehabilitationofelderlyhipfracturepatients.Rehabilitationisanimportantpartofthemanagementofhipfractures,asithelpstorestoremobilityandindependenceandpreventfuturefallsandfractures.However,rehabilitationcanbechallengingforelderlypatients,particularlythosewithcomorbiditiesorcomplicationssuchascognitiveimpairmentorpressureulcers.Theuseofpercutaneouselectricalstimulationincombinationwithconventionalrehabilitationtechniquesmayhelptoimprovetheeffectivenessandefficiencyofrehabilitationinthesepatients(Maetal.,2017;Zhangetal.,2018).Forexample,inarandomizedcontrolledtrialofelderlypatientswithhipfractures,thosewhoreceivedpercutaneouselectricalstimulationalongwithconventionalrehabilitationhadsignificantlyimprovedwalkingspeed,abilitytoperformactivitiesofdailyliving,andqualityoflifecomparedtothosewhoreceivedconventionalrehabilitationalone(Heetal.,2018).

Overall,percutaneousacupointelectricalstimulationisapromisingnewmethodformanagingthecomplexneedsofelderlyhipfracturepatients.Thistechniqueissafe,non-invasive,andcanbeeasilyappliedbytrainedhealthcarepractitioners.However,furtherresearchisneededtodeterminetheoptimalprotocolsforusingthismethodindifferentpatientpopulationsandclinicalsettings.Additionally,moreresearchisneededtoclarifytheunderlyingmechanismsofactionofpercutaneouselectricalstimulationandtoidentifythepatientswhoaremostlikelytobenefitfromthistreatment.Withongoingresearchanddevelopment,percutaneousacupointelectricalstimulationhasthepotentialtobecomeanimportanttoolforimprovingtheoutcomesofelderlyhipfracturepatientsandenhancingthequalityoftheircareFurthermore,itisimportanttoexplorethefeasibilityandefficacyofintegratingpercutaneouselectricalstimulationintomultidisciplinaryrehabilitationprogramsforelderlyhipfracturepatients.Rehabilitationfollowinghipfracturecanbeacomplexandchallengingprocess,requiringtheinputofmultiplehealthcareprofessionals.Therefore,itisimportanttodeterminehowpercutaneouselectricalstimulationcanbeintegratedintoexistingrehabilitationprogramswithoutdisruptingtheholisticapproachtocare.

Itisalsoimportanttoconsiderthepotentialcost-effectivenessofpercutaneouselectricalstimulationinthemanagementofelderlyhipfracturepatients.Whiletheinitialcostofdevicesforpercutaneouselectricalstimulationmaybehigh,thelong-termbenefitsintermsofimprovedmobilityandreducedhealthcarecostsmayoutweightheinitialinvestment.Cost-effectivenessanalysisisneededtodeterminewhetherpercutaneouselectricalstimulationrepresentsgoodvalueformoneycomparedtoothertreatmentsforhipfracturepatients.

Anotherareaforfutureresearchisthepotentialuseofpercutaneouselectricalstimulationforthepreventionofhipfracturesinelderlyindividuals.Hipfracturesareamajorpublichealthconcern,withsignificantmorbidity,mortality,andeconomicburden.Therefore,identifyingeffectivepreventionstrategiesisakeypriority.Itisplausiblethatpercutaneouselectricalstimulationcouldhelptopreventhipfracturesbyimprovingbonedensityandreducingtheriskoffalls.However,furtherresearchisneededtodeterminethefeasibilityandefficacyofthisapproach.

Finally,itisimportanttoconsidertheethicalimplicationsofpercutaneouselectricalstimulationforelderlyhipfracturepatients.Forexample,somepatientsmaynotwanttoreceivethistreatmentduetoconcernsaboutpainordiscomfort.Therefore,itisimportanttoensurethatpatientsarefullyinformedaboutthepotentialbenefitsandrisksofpercutaneouselectricalstimulationbeforeconsentingtotheprocedure.Additionally,itisimportanttoconsiderfactorssuchaspatientautonomy,confidentiality,andrespectforculturalbeliefsandvalueswhendeliveringthistreatment.

Inconclusion,percutaneouselectricalstimulati