临床护理路径在腹部S型皮瓣治疗手部撕脱伤患者中的应用  

The application effects of CNP in patients with abdominal S-shaped flap in repairing hand detachment injury

作　　者：张瑛[1] 杨新明[1] ZHANG Ying;YANG Xinming(The First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院骨科,河北省张家口市075000

出　　处：《河北医药》2021年第21期3343-3346,共4页Hebei Medical Journal

基　　金：河北省临床重点专科资助项目。

摘　　要：目的探讨临床护理路径(clinical nursing path,CNP)在腹部S型瓦合真皮下血管网皮瓣(腹部S型皮瓣)修复手部脱套伤患者治理护理中的应用效果。方法选取符合纳入标准患者32例,其中男24例,女8例;年龄23~52岁,平均(37.0±2.1)岁。致伤原因:机器性撕脱伤20例,交通事故12例。手部脱套伤部位:手掌背部脱套伤14例,手指脱套伤18例(20个指),其中食指5例,拇指8例,无名指3例,食指合并中指1例,中指合并无名指1例。32例患者依据数字表法随机分为常规护理组(对照组)和CNP干预护理组(观察组),每组16例。2组患者均进行整体护理,观察组制定个性化的临床护理路径护理日程计划表。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、疼痛视觉模拟评分(VAS)、皮瓣断蒂时间、平均住院时间、住院患者护理满意度测评量表、生活质量综合评定问卷(GQOLI-74)作为治疗护理评价指标。结果2组术前SAS、SDS、VAS评分比较差异无统计学意义(P>0.05),术后观察组SAS、SDS和VAS明显优于对照组(P<0.05)。观察组术后皮瓣断蒂时间较早于对照组,住院时间明显少于对照组(P<0.05)。观察组护理模式的满意度和生活质量GQOLI-74评分明显优于对照组(P<0.05)。结论CNP干预可有效缓解腹部S型皮瓣修复手部撕脱伤患者焦虑、抑郁状态,可以较传统皮瓣提前断蒂,减少平均住院时间,加速快速康复,提高护理满意度及患者生活质量,具有很好的护理应用效果。Objective To investigate the application effects of clinical nursing path(CNP)in patients with abdominal S-shaped tile-shaped subdermal vascular network flap(abdominal S-shaped flap)in repairing hand detachment injury.Methods A total of 32 patients were enrolled in the study,including 24 males and 8 females,with age range:23~52yr[average age:(37.0±2.1)years],of whom,there were 20 cases of mechanical avulsions and 12 cases of traffic accidents.The 32 patients were randomly divided into routine care group(control group)and CNP intervention care group(observation group)according to the digital table method.The patients in both groups were treated by holistic nursing,on that basis,a personalized clinical nursing path nursing schedule was formulated in observation group.Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Visual Analogue Scale of Pain(VAS),flap pedicle duration,average hospital saty,nursing satisfaction assessment scale and Generic Quality of Life Inventory-74(GQOLI-74)were used to evaluate the nursing and treatment indexes.Results Before surgery there were no significant differences in the scores of SAS,SDS and VAS between the two groups(P>0.05).After operation the indexes in observation group were significantly better than those in control group(P<0.05).The flap pedicle rupture time in observation group was significantly earlier than that in control group,and the hospitalization time was significantly shorter than that in control group(P<0.05).Moreover the life quality GQOLI-74 scores and satisfaction in observation group were superior to those in control group(P<0.05).Conclusion CNP intervention can effectively relieve the anxiety and depression state of patients with abdomen S-type flap repair of hand avulsion injury,which can reduce the average hospital stay,accelerate recovery,improve nursing satisfaction and life quality of patients.

关 键 词：手部脱套伤 皮瓣 临床护理路径 负性情绪 护理满意度 生活质量 

分 类 号：R473.6[医药卫生—护理学]