心理弹性干预结合前瞻性护理在行游离皮瓣移植修复四肢皮肤软组织缺损患者中的应用  

Application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities

作　　者：王会聪[1] 张含[1] 成巧梅[2] 李卓亚[1] 葛玉[1] 刘东苗[1] Wang Huicong;Zhang Han;Cheng Qiaomei;Li Zhuoya;Ge Yu;Liu Dongmiao(Department of Hand and Foot Microsurgery,Henan Provincial People's Hospital,Zhengzhou 450000,China;Internet Intelligence,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院手足显微外科,郑州450000 [2]河南省人民医院互联智慧,郑州450000

出　　处：《中华现代护理杂志》2021年第19期2619-2623,共5页Chinese Journal of Modern Nursing

基　　金：2018年河南省科技研发专项项目(182102310092)。

摘　　要：目的探讨心理弹性干预结合前瞻性护理在行游离皮瓣移植修复四肢皮肤软组织缺损患者中的应用。方法采取便利抽样法选择河南省人民医院2019年10月—2020年10月收治的65例经游离皮瓣移植修复后四肢皮肤出现软组织损伤患者,按入院时间分为观察组(34例)与对照组(31例)。观察组患者采取心理弹性干预结合前瞻性护理,对照组患者单纯行前瞻性护理。比较两组患者的手术成功率、皮瓣坏死率、血管危象发生率及并发症情况,采用症状自评量表(SCL-90)评估干预前后两组患者的治疗效果。结果观察组患者的手术成功率、皮瓣坏死率、血管危象发生率(100.00%、2.94%、2.94%)与对照组(96.77%、12.90%、16.13%)比较,差异均无统计学意义(P>0.05);观察组患者出现1例DVT及2例其他并发症,对照组出现3例压力性损伤、1例感染、2例DVT与3例其他并发症;观察组的总并发症发生率为8.82%,低于对照组的29.03%,差异有统计学意义(P<0.05);干预后观察组的焦虑、偏执因子评分均低于对照组,差异有统计学意义(P<0.05)。结论心理弹性干预结合前瞻性护理在行游离皮瓣移植修复四肢皮肤后软组织缺损患者中应用效果较好,患者并发症发生率降低,心理健康状况良好。Objective To explore the application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities.Methods Using the convenient sampling method,a total of 65 patients with soft tissue injury in the skin of extremities after undergoing free skin flap transplantation who were admitted to Henan Provincial People's Hospital from October 2019 to October 2020 were selected.According to the admission time,they were divided into the observation group(34 cases)and the control group(31 cases).Patients in the observation group received psychological resilience intervention combined with prospective nursing,while patients in the control group only received prospective nursing.The surgical success rate,flap necrosis rate,incidence of vascular crisis and complications were compared between the two groups.Symptom Checklist-90(SCL-90)was used to evaluate treatment effects of patients in two groups before and after the intervention.Results There was no statistically significant difference in the surgical success rate,flap necrosis rate and incidence of vascular crisis between the observation group(100.00%,2.94%,2.94%)and the control group(96.77%,12.90%,16.13%)(P>0.05).The observation group had 1 case of deep venous thrombosis(DVT)and 2 cases of other complications,and the control group had 3 cases of pressure injury,1 case of infection,2 cases of DVT and 3 cases of other complications.The complication rate in the observation group was 8.82%,which was lower than 29.03%in the control group,and the difference was statistically significant(P<0.05).After intervention,the scores of anxiety and paranoia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Psychological resilience intervention combined with prospective nursing has a good application effect on patients with free skin flap transplantation to repair skin and soft tissue defect

关 键 词：软组织缺损 皮瓣移植 心理弹性 前瞻性护理 心理护理 

分 类 号：R473.6[医药卫生—护理学]