截肢者术后住院期间并发症及预测因素的文献分析  

Literature analysis of complications and predictive factors of amputees during postoperative hospitalization

作　　者：林梦[1,2] 张亚清 杨帆[4] 闫地瑞[5] 苏锋华 李斯俭 LIN Meng;ZHANG Yaqing;YANG Fan;YAN Dirui;SU Fenghua;LI Sijian(Department of Pediatric Genetics,Metabolism and Endocrinology Nursing,West China Second University Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Key Laboratory of Birth Defects and Related Diseases of Women and Chi Idren(Sichuan University),Ministry of Education,Chengdu,Sichuan 610041,P.R.China;Department of Orthopaedics,Mianyang Central Hospital,Mianyang,Sichuan 621000,P.R.China;Department of Neurointensive Care Unit,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Newborn,West China Second University Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Emergency Intensive Care Unit,Fujian Provincial Hospital,Fuzhou,Fujian 350001,P.R.China;School of Nursing,the Hong Kong Polytechnic University,Hong Kong 999077,P.R.China)

机构地区：[1]四川大学华西第二医院小儿遗传代谢内分泌科护理单元/四川大学华西护理学院,成都610041 [2]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041 [3]绵阳市中心医院骨科,四川绵阳621000 [4]四川大学华西医院神经重症监护室,成都610041 [5]四川大学华西第二医院新生儿科,成都610041 [6]福建省立医院急诊重症监护室,福州350001 [7]香港理工大学护理学院,中国香港999077

出　　处：《华西医学》2022年第4期561-567,共7页West China Medical Journal

摘　　要：目的 分析截肢者术后住院期间主要并发症及预测因素,为截肢者护理及早期康复提供证据参考。方法 采用文献计量学方法,在Embase、Ovid、Medline、PubMed、CINAHL、中国知网、万方和维普数据库中检索2008年1月1日-2022年4月5日发表的截肢者术后住院期间主要并发症及预测因素相关文献,对文章类型、样本量、截肢原因、截肢部位、并发症、影响因素、预测因素、处理建议等进行统计学描述和分析。结果 最终纳入19篇文献,其中英文16篇,中文3篇,均为定量研究。文献质量评分≥7分,均为好或优秀水平。文献类型以回顾性研究为主(n=15),研究内容主要为下肢截肢。截肢原因主要为周围血管疾病及糖尿病(n=11)。伤口感染、贫血、幻肢痛、心理问题是截肢术后常见并发症,并发症、二次手术、死亡的预测因素包括年龄、性别、吸烟、饮酒、肥胖、术前合并症、截肢水平、麻醉方式等多方面因素。结论 截肢术后急性期护理重点是伤口愈合、疼痛控制、近端身体运动和情感支持,尤其是截肢者术后心理问题突出,需要及早进行心理疾病筛查及精神支持。截肢术后需由多学科、多团队协调护理,实现患者身体、心理双治愈,促进其尽早康复。Objective To analyze the major complications and predictive factors of amputees during postoperative hospitalization, and provide a reference for amputees nursing and early rehabilitation. Methods Using the bibliometric method, we searched Embase, Ovid, Medline, PubMed, CINAHL, China National Knowledge Infrastructure,Wanfang and CQVIP databases for the data of postoperative hospitalization of amputees published from January 1st, 2008to April 5th, 2022. Statistical description and analysis of article types, sample size, reasons for amputation, amputation sites, complications, influencing factors, predictive factors, and treatment recommendations were performed.Results Finally, 19 articles were included, including 16 in English and 3 in Chinese, all of which were quantitative studies. The literature quality scores were greater than or equal to 7 points, which were all good or excellent. The type of articles were mainly retrospective research(n=15), and the research contents were mainly lower limb amputation. The main reasons for amputation were peripheral vascular disease and diabetes mellitus(n=11). Wound infection, anemia,phantom limb pain, and psychological problems were common complications after amputation. Predictors of complications, secondary operations, and death included age, gender, smoking, drinking, obesity, preoperative comorbidities, level of amputation, anesthesia methods and other factors. Conclusions The focus of acute care after amputation should be wound healing, pain control, proximal physical movement and emotional support, especially for amputees who have prominent postoperative psychological problems. These patients need early psychological disease screening and mental support. After amputation, multi-disciplinary and multi-team coordinated care are needed to achieve both physical and psychological healing of the patient and promote early recovery.

关 键 词：截肢者 并发症 预测因素 文献计量 

分 类 号：R473.6[医药卫生—护理学]