帶蒂皮瓣移植修復(fù)指端軟組織缺損的圍術(shù)期整體護(hù)理

陳斯　梁?！↑S曉瑜　吳春珍　譚潔　鄭嘉慧　廖海英

【摘要】 目的：評價(jià)整體護(hù)理應(yīng)用于帶蒂皮瓣移植修復(fù)指端軟組織缺損圍術(shù)期內(nèi)的效果。方法：回顧性分析2015年1月-2018年12月本院收治的82例行帶蒂皮瓣移植修復(fù)指端軟組織缺損手術(shù)治療患者的臨床資料，按不同護(hù)理措施分為對照組、試驗(yàn)組各41例。對照組應(yīng)用圍術(shù)期常規(guī)護(hù)理，試驗(yàn)組應(yīng)用圍術(shù)期整體護(hù)理，對比兩組患者的疼痛程度、并發(fā)癥發(fā)生率、皮瓣成活率及護(hù)理滿意度。結(jié)果：試驗(yàn)組患者的疼痛程度、并發(fā)癥發(fā)生率均低于對照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;試驗(yàn)組患者的皮瓣成活率、護(hù)理滿意度均高于對照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：在帶蒂皮瓣移植修復(fù)指端軟組織缺損手術(shù)圍術(shù)期，實(shí)施整體護(hù)理措施，不僅可以改善患者疼痛程度、降低并發(fā)癥發(fā)生率，又能提高皮瓣成活率、患者護(hù)理滿意度，值得臨床推廣應(yīng)用。

【關(guān)鍵詞】 整體護(hù)理; 帶蒂皮瓣移植修復(fù); 指端軟組織缺損; 圍術(shù)期; 并發(fā)癥

【Abstract】 Objective：To evaluate the effect of holistic nursing in the perioperative period of pedicled skin flap transplantation for repairing fingertip soft tissue defect.Method：From January 2015 to December 2018，the clinical data of 82 patients with fingertip soft tissue defect treated by pedicled skin flap transplantation in our hospital were retrospectively analyzed.According to different nursing measures，82 patients were divided into control group and experimental group，41 cases in each group.The control group was given perioperative routine nursing，while the experimental group was given perioperative holistic nursing.The degree of pain，incidence of complications，the survival rate of skin flaps and nursing satisfaction were compared between the two groups.Result：The pain degree and complication rate in the experimental group were lower than those in the control group，there were statistical significance（P<0.05）.The survival rate of skin flaps and nursing satisfaction in the experimental group were higher than those in the control group，there were statistical significance（P<0.05）.Conclusion：In the surgical treatment of fingertip soft tissue defect with pedicled skin flap transplantation，the implementation of holistic nursing measures can not only improve the degree of pain，reduce the incidence of complications，but also improve the survival rate of skin flap and nursing satisfaction，which is worthy of clinical application.

【Key words】 Holistic nursing; Pedicled skin flap transplantation for repair; Fingertip soft tissue defect; Perioperative period; Complication

First-authors address：Shenzhen Longhua District Peoples Hospital，Shenzhen 518109，China

doi：10.3969/j.issn.1674-4985.2019.09.027

指端軟組織缺損屬于臨床常見病，臨床統(tǒng)計(jì)表明，手指外傷在我國工傷致殘占比較大，也是主要的創(chuàng)傷疾病之一[1-3]。指端軟組織缺損不僅會(huì)影響手部外觀感，還會(huì)喪失一部分手功能，給患者身心帶來嚴(yán)重的創(chuàng)傷。隨著人們生活質(zhì)量的不斷提高，人們對于手部的美感要求越來越高。在指端軟組織缺損治療中，臨床多采用殘端修整術(shù)，雖具有一定的治療效果，實(shí)現(xiàn)修復(fù)創(chuàng)面的目的，但創(chuàng)傷修復(fù)后，手部的感覺、外觀、運(yùn)動(dòng)功能、指甲缺乏等均不能令患者滿意，盡管醫(yī)療水平的不斷進(jìn)步，拇甲瓣移植治療也會(huì)出現(xiàn)較大的創(chuàng)傷，對于手部功能的恢復(fù)影響較大[4-6]，故患者接受度較差。隨著皮瓣修復(fù)技術(shù)的進(jìn)步，帶蒂皮瓣移植修復(fù)應(yīng)用于指端軟組織缺損治療中，對修復(fù)手部皮膚軟組織與恢復(fù)手功能具有積極作用[7-9]。如在帶蒂皮瓣移植修復(fù)指端軟組織缺損圍術(shù)期內(nèi)，配合整體護(hù)理措施，對減少并發(fā)癥、促使患者病情盡快康復(fù)具有積極的臨床意義。本次研究針對整體護(hù)理應(yīng)用于帶蒂皮瓣移植修復(fù)指端軟組織缺損的圍術(shù)期內(nèi)的效果進(jìn)行評價(jià)，取82例患者開展本次研究，現(xiàn)報(bào)道如下。