动脉化静脉皮瓣移植术后临床表现分型及其护理对策  

Postoperative clinical classification and nursing strategies for the arterialized venous flap transplantation

作　　者：赵彬[1] 罗小斌 饶世鸣[2] 吴志鹏[2] 李志杰[2] 闫合德[2] Zhao Bin;Luo Xiaobin;Rao Shiming;Wu Zhipeng;Li Zhijie;Yan Hede(Department of Post-anesthesia Care Unit,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Hand and Plastic Surgery,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院麻醉复苏室,浙江温州325027 [2]温州医科大学附属第二医院手显微外科,浙江温州325027

出　　处：《温州医科大学学报》2020年第6期500-505,共6页Journal of Wenzhou Medical University

基　　金：浙江省自然科学基金资助项目(LY18H060010);温州市科技局科研基金资助项目(Y20180667)。

摘　　要：目的:对动脉化静脉皮瓣移植术后的不同临床表现进行分型,以便采取针对性护理干预,改善其成活状况,提高皮瓣成活率。方法:收集2010年6月至2019年3月温州医科大学附属第二医院采用动脉化静脉皮瓣游离移植修复的所有临床病例资料,根据其术后皮瓣颜色、皮瓣张力、肿胀程度、水泡形成以及淤血等情况,采用个体化护理干预措施,以皮瓣最终成活状况作为最主要的观察评价指标,进行系统总结分析。结果:共收集64例,68个动脉化静脉皮瓣,根据其术后表现情况分为正常生理皮瓣型(NPF型,25例,27个)、水泡形成型(BF型,18例,18个)和淤血肿胀型(CS型,21例,23个)。其中,NPF型皮瓣全部成活,BF型皮瓣仅1个部分坏死,CS型皮瓣虽经积极保守治疗,有1个完全坏死和2个部分坏死。结论:动脉化静脉皮瓣移植术后临床表现差异较大,需根据不同的临床分型,加强护理观察,采取针对性术后护理干预措施,以提高其整体成活状况。Objective:To classify different clinical manifestations after arterialized venous flap transplantation in order to take targeted nursing interventions for the improvement of flap survival.Methods:All the cases reconstructed with free arterialized venous flaps in the Second Affiliated Hospital of Wenzhou Medical University from June 2010 to March 2019 were collected.A systematic analysis was carried out in terms of the color and tension of the flaps,the degree of swelling,the formation of blisters and the congestion status.Nursing interventions were adopted individually according to different clinical features.The survival of the flaps was taken as the main evaluation parameter.Results:A total of 64 cases including 68 arterialized venous flaps were included.According to their postoperative features,they were divided into three types:the normal physiological flap type(NPF type,25 cases,27 flaps),the blister formation type(BF type,18 cases,18 flaps),and the congestion swelling type(CS type,21 cases,23 flaps).Among them,all the NPF type survived uneventfully;only one partial flap loss occurred in the BF type and two partial and one total flap loss were encountered in the CS type after active conservative management.Conclusion:The clinical manifestations of arterial venous flaps are quite different.It is essential to strengthen postoperative observation and nursing interventions according to different clinical types.

关 键 词：动脉化静脉皮瓣 临床分型 术后护理 护理观察 

分 类 号：R473.6[医药卫生—护理学]