断指再植术后采用不同时相点暴露疗法的效果观察  

Therapeutic effect of exposed wound care at different time point after finger replatation

作　　者：胡三莲[1] 许鑫[2] 许燕玲[1] 陆惠芳[2] 薛翌蔚[2] 翁羽犟 

机构地区：[1]上海市第六人民医院护理部,200233 [2]上海市第六人民医院骨科

出　　处：《中华现代护理杂志》2009年第34期3591-3593,共3页Chinese Journal of Modern Nursing

基　　金：基金项目：2007年上海交通大学医学院校级立项课题（Jyh0705）;2006年上海市第六人民医院院级课题（0625）

摘　　要：目的探讨在断指再植术后采用不同时相点暴露疗法对护理效果的影响。方法选取断指再植术后患者605例，按照术后伤口开始暴露疗法的不同时间分为4组，A组术后1～2h开始，B组术后6～8h，C组术后12—24h，D组术后实施全程敷料包扎疗法至14d伤口拆线；比较4组在再植手指血液循环、伤口感染、存活率、医疗成本等方面差异。结果B组再植手指成功率99．5％，其血液循环、伤口感染、医疗成本等方面均优于其他组，并使平均医疗费用、住院时间、并发症均减少。结论在断指再植术后6～8h实施暴露疗法，可降低再植手指血管危象的发生率，降低医疗成本支出，提高再植手指的成活率。Objective To explore the influence to nursing efficiency using exposed wound care （EWC） at different time point after finger replantation. Methods 605 patients after finger replantation were recruited according to selection criteria and were randomly divided into 4 groups. 136 eases in group A were treated with EWC without gauze dressing cover 1 to 2 hours after operation. 183 eases in group B were treated with EWC 6 to 8 hours after operation. 159 cases group C were treated with EWC 12 to 24 hours after operation. 127 eases in group D were treated with gauze dresssing cover all the time until taking the stiches out （ 14 days）. Blood circulation, wound infection, finger survival rate, medical costs were observed and compared among 4 groups. Results Compared with the other 3 groups, group B had better outcomes including blood circulation, wound infection, survival rate and medical costs of replanted finger. The EWC therapy could decrease expenditures of inpatient, length of stay, and incidence of complications. Conclusions The EWC therapy should be used 6 to 8 hours after operation when dressing oozing did not dry completely. That therapy can decrease the incidence of blood vessel crisis of replanted finger, reduce medical expenditures and improve survival rate of replanted finger.

关 键 词：暴露疗法 断指再植 时相点 伤口护理 

分 类 号：R473.6[医药卫生—护理学]