切换至 "中华医学电子期刊资源库"

中华老年骨科与康复电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 117 -122. doi: 10.3877/cma.j.issn.2096-0263.2020.02.010

所属专题: 文献

护理园地

规范化护理干预在上肢损伤皮瓣移植术后患者中的应用
肖丽亚1, 闫林平2, 高小雁3,()   
  1. 1. 528000 佛山市第二人民医院骨科
    2. 050011 石家庄市第三医院护理部
    3. 100035 北京市积水潭医院护理部
  • 收稿日期:2020-02-16 出版日期:2020-04-05
  • 通信作者: 高小雁
  • 基金资助:
    河北省医学科学研究重点课题(08323)

Application of standardized nursing in patients with upper limb injury after skin flap transplantation

Liya Xiao1, Liping Yan2, Xiaoyan Gao3,()   

  1. 1. Department of Orthopedics, the Second People's Hospital of Foshan
    2. Department of Nursing, the Third People's Hospital, Shijiazhuang 050011, China
    3. Department of Nursing, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2020-02-16 Published:2020-04-05
  • Corresponding author: Xiaoyan Gao
引用本文:

肖丽亚, 闫林平, 高小雁. 规范化护理干预在上肢损伤皮瓣移植术后患者中的应用[J/OL]. 中华老年骨科与康复电子杂志, 2020, 06(02): 117-122.

Liya Xiao, Liping Yan, Xiaoyan Gao. Application of standardized nursing in patients with upper limb injury after skin flap transplantation[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(02): 117-122.

目的

探讨规范化护理干预在上肢损伤皮瓣移植术后患者中的应用效果。

方法

采用方便抽样法,前瞻性收集2015年1月到2018年5月我院收治的80例上肢损伤行皮瓣移植术患者为研究对象,按照入院时间顺序分为对照组和试验组各40例,对照组采用常规护理方法,试验组在常规护理基础上实施规范化护理干预措施,比较两组患者术后疼痛程度、术后皮瓣成活率及平均住院时间。

结果

干预后试验组患者轻度疼痛28例(70.0%),高于对照组的13例(32.5%);中度疼痛6例(15.0%),低于对照组的10例(25.0%);重度疼痛6例(15.0%),低于对照组的17例(42.5%),差异均有统计学意义(P<0.05)。试验组患者术后带蒂皮瓣成活38例(95.0%),高于对照组的36例(90%),两组比较差异有统计学意义(P<0.05)。试验组患者平均住院时间为(21.6±1.8)d,低于对照组的(31.3±5.4)d,差异有统计学意义(P<0.05)。

结论

采取规范化的护理措施对上肢损伤皮瓣移植术后患者进行干预,可有效提高皮瓣成活率,缩短住院时间,提高患者满意度。

Objective

To investigate the effect of standardized nursing care on patients' prognosis after skin flap transplantation for upper limb injury.

Methods

Using the convenient sampling method, 80 patients with pedicled flap transplantation for upper limb injuries who were treated from January 2015 to May 2018 were selected as the research objects. They were divided into the control group and the experimental group according to the order of admission, with 40 cases in each. The control group used conventional nursing methods, and the experimental group performed normal surgical intervention on the basis of conventional nursing. The postoperative pain, survival rate of flaps, and length of hospital stay were compared between the two groups.

Results

After the intervention, 28 patients (70.0%) in the experimental group had mild pain, which was higher than 13 (32.5%) in the control group; 6 patients (15.0%) had moderate pain, which was lower than 10 (25.0%) in the control group; 6 were severe pain. The number of cases (15.0%) was lower than that in the control group (17.42.5%). The difference between the two groups was statistically significant (P<0.05). Thirtyeight patients (95.0%) survived with pedicled flaps in the experimental group after surgery, which was higher than the 36 patients (90%) in the control group, The difference between the two groups was statistically significant (P<0.05). The length of hospital stay in the test group was (21.6±1.8) days, which was lower than that in the control group (31.3±5.4) days. There was a statistically significant difference between the two groups (P<0.05).

Conclusion

Patients with skin flaps need standardized nursing measures, which can effectively improve the survival rate of the flaps, shorten the length of hospital stay, and greatly improve patient satisfaction.

表1 两组行皮瓣治疗患者一般资料比较
图1~5 皮瓣颜色。图1潮红色;图2粉红色;图3苍白色;图4紫色;图5黑色
表2 两组行皮瓣治疗患者术后疼痛程度比较[n(%)]
表3 两组行皮瓣治疗患者皮瓣存活率比较[n(%)]
表4 两组行皮瓣治疗患者住院时间比较(d,±s
1
侯春林, 顾玉东. 皮瓣外科学[M]. 上海: 上海科学技术出版社, 2006.
2
Lu TC, Lin CH, Lin CH, et al. Versatility of the pedided peroneal artery perforator flaps for soft-tissue coverage of the lower leg and foot defects [J]. J Plast Reconstr Aesthet Surg, 2011, 64(3): 386-393.
3
刘明明,彭伶丽. 皮瓣移植术后非侵入性微循环监测方法的进展[J]. 中华显微外科杂志, 2019, 42(2): 208,后插1-后插3.
4
喻石,刘毅,李玉环, 等. 各类皮瓣移植术后静脉危象护理体会[J]. 中华显微外科杂志, 2017, 40(6): 612-613.
5
白艳,徐永清,李军, 等. 穿支皮瓣移植术围手术期护理流程的优化设计与应用效果[J]. 西南国防医药, 2019, 29(9): 971-974.
6
殷夕娣,刘敏,赵波. 游离皮瓣移植术后并发症的护理观察与应对策略[J]. 中华显微外科杂志, 2018, 41(3): 299-300.
7
刘晓芳. 断指再植术后发生血管危象的原因分析及处理对策[J]. 中华显微外科杂志, 2005, 28(3): 274-276.
8
韩素琴,王欣,胡浩良, 等. 改良远端蒂腓动脉穿支螺旋桨皮瓣修复小腿及足踝部软组织缺损的围手术期护理[J]. 中华显微外科杂志, 2018, 41(2): 201-202.
9
郑淑芬. 综合护理干预在手外伤患者皮瓣移植术后的应用研究[J]. 中外医学研究, 2020, 18(04): 111-113.
10
豆楠楠. 综合性护理手外伤皮瓣移植术患者44例[J]. 河南医学高等专科学校学报, 2018, 30(3): 279-281.
11
蒋乐萍,高伟阳,杜丽媚,等. 舒适护理在手外伤皮瓣移植术中的应用效果[J]. 中国现代医生, 2015, 53(32): 145-148.
12
王吉. 口腔颌面外科手术后感染因素及护理对策[J]. 中国社区医师, 2019, 35(27): 155, 157.
13
张鹏,李元新,赵宏伟, 等. 腹腔镜阑尾切除术后住院时间影响因素的Logistic回归分析[J]. 中国数字医学, 2020, 15(01): 136-138.
[1] 周容, 张亚萍, 廖宇, 程晓萍, 管玉龙, 潘广玉, 闫杰, 王贤芝, 苟中山, 潘登科, 李巅远. 超声在基因编辑猪-猴异种并联式心脏移植术中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 617-623.
[2] 梁晓宗, 江吉勇, 李曼丹, 林海彬, 王昌义. 阔筋膜游离股前外侧穿支皮瓣修复足踝组织缺损[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 672-675.
[3] 杨成鹏. 以旋股外侧动脉前支为蒂的股前外侧皮瓣临床应用研究[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(01): 92-92.
[4] 李友, 唐林峰, 杜伟伟, 刘海亮, 余新水, 沈佳宇, 巨积辉. 皮瓣联合掌长肌腱折叠单排三点式固定治疗指背侧创面伴锤状指畸形的临床效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 485-490.
[5] 高秋芳, 张万锋, 盛泉音, 马彬. 足底内侧皮瓣联合腓动脉穿支皮瓣修复足跟部巨大恶性黑色素瘤切除后创面的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 491-497.
[6] 林同辉, 杨卫玺. 股前外侧穿支皮瓣在电烧伤治疗中应用的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 526-530.
[7] 傅红兴, 王植楷, 谢贵林, 蔡娟娟, 杨威, 严盛. 间充质干细胞促进胰岛移植效果的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 351-360.
[8] 魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治(附四例报告)[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[9] 傅斌生, 冯啸, 杨卿, 曾凯宁, 姚嘉, 唐晖, 刘剑戎, 魏绪霞, 易慧敏, 易述红, 陈规划, 杨扬. 脂肪变性供肝在成人劈离式肝移植中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 789-794.
[10] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[11] 陈秀梅, 陈思涓, 郑小静. 护理联盟体构建及实践的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 703-708.
[12] 广东省护士协会介入护士分会, 广东省医师协会介入医师分会. 原发性肝癌低血糖患者护理规范管理专家共识[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 709-714.
[13] 吴荣奎, 吴静, 冯俊浩, 钟嘉懿. 临床护理路径在经股动脉入路介入患者的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 729-733.
[14] 于洁, 金小红, 顾艳楣, 王慧, 葛杨杨, 李燕. 癌症相关静脉血栓栓塞症患者疾病体验与需求的质性研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 739-744.
[15] 阳跃, 庹晓晔, 崔子豪, 欧阳四民, 林海阳, 胡景宇, 胡银, 李涛, 赵景峰, 郝岱峰, 冯光. 改良“阅读者”皮瓣修复骶尾部压疮的疗效[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 751-755.
阅读次数
全文


摘要