帶蒂皮瓣移植修復指端軟組織缺損的圍術期整體護理

陳斯　梁海　黃曉瑜　吳春珍　譚潔　鄭嘉慧　廖海英

【摘要】 目的：評價整體護理應用于帶蒂皮瓣移植修復指端軟組織缺損圍術期內的效果。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指端軟組織缺損手術治療患者的臨床資料，按不同護理措施分為對照組、試驗組各41例。對照組應用圍術期常規護理，試驗組應用圍術期整體護理，對比兩組患者的疼痛程度、并發癥發生率、皮瓣成活率及護理滿意度。結果：試驗組患者的疼痛程度、并發癥發生率均低于對照組，差異均有統計學意義（P<0.05）;試驗組患者的皮瓣成活率、護理滿意度均高于對照組，差異均有統計學意義（P<0.05）。結論：在帶蒂皮瓣移植修復指端軟組織缺損手術圍術期，實施整體護理措施，不僅可以改善患者疼痛程度、降低并發癥發生率，又能提高皮瓣成活率、患者護理滿意度，值得臨床推廣應用。

【關鍵詞】 整體護理; 帶蒂皮瓣移植修復; 指端軟組織缺損; 圍術期; 并發癥

【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，臨床統計表明，手指外傷在我國工傷致殘占比較大，也是主要的創傷疾病之一[1-3]。指端軟組織缺損不僅會影響手部外觀感，還會喪失一部分手功能，給患者身心帶來嚴重的創傷。隨著人們生活質量的不斷提高，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，雖具有一定的治療效果，實現修復創面的目的，但創傷修復后，手部的感覺、外觀、運動功能、指甲缺乏等均不能令患者滿意，盡管醫療水平的不斷進步，拇甲瓣移植治療也會出現較大的創傷，對于手部功能的恢復影響較大[4-6]，故患者接受度較差。隨著皮瓣修復技術的進步，帶蒂皮瓣移植修復應用于指端軟組織缺損治療中，對修復手部皮膚軟組織與恢復手功能具有積極作用[7-9]。如在帶蒂皮瓣移植修復指端軟組織缺損圍術期內，配合整體護理措施，對減少并發癥、促使患者病情盡快康復具有積極的臨床意義。本次研究針對整體護理應用于帶蒂皮瓣移植修復指端軟組織缺損的圍術期內的效果進行評價，取82例患者開展本次研究，現報道如下。