水凝胶与常规换药在儿童肱骨髁上骨折术后外露克氏针钉道护理中的疗效比较  

Comparison of the effect of hydrogel and routine dressing change in the nursing care of children with supracondylar humerus fracture after operation with exposed Kirschner wire and nail path

作　　者：李萍[1] 陈宏如 刘德纬 唐小燕 陈少婷[1] LI Ping;CHEN Hongru;LIU Dewei;TANG Xiaoyan;CHEN Shaoting(Department of Pediatric Orthopaedics,The 910 Hospital of PLA,Quanzhou,Fujian 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院小儿骨科,福建泉州362000

出　　处：《现代医药卫生》2023年第15期2584-2588,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨水凝胶换药在儿童肱骨髁上骨折术后外露克氏针钉道护理中的效果。方法选取2018年9月至2020年5月该院小儿骨科收治的儿童肱骨髁上骨折患儿183例,其中男101例,女82例;年龄1~13岁,平均(7.32±4.38)岁;体重指数18.71~22.54 kg/m 2,平均(20.37±1.08)kg/m 2。所有患儿均急诊行闭合复位克氏针固定术,克氏针数量3~4枚,平均(3.32±0.18)枚;直径1.5~2.0 mm,平均(1.63±0.90)mm。根据不同护理方法分为水凝胶组(采用水凝胶进行钉道护理,81例)和对照组(采用常规钉道护理,102例)。记录2组患儿视觉模拟疼痛量表评分、钉道愈合情况、浅表及深部感染情况、感染菌种等。结果水凝胶组患儿第1~4周视觉模拟疼痛量表评分、钉道浅表及深部感染率均明显低于对照组,钉道甲、丙级愈合率均明显优于对照组,差异有统计学意义(P<0.05);2组患儿钉道乙级愈合率比较,差异无统计学意义(P>0.05)。2组患儿深部感染细菌的菌种类型均与浅部感染相同。结论儿童肱骨髁上骨折术后采用水凝胶进行钉道护理可提高钉道愈合程度,继而减少钉道疼痛和细菌感染,尤其是深部感染发生率,具有高效、操作简便、安全等优点。Objective To investigate the effect of hydrogel dressing change in the nursing care of exposed's Kirschner needle pin path after supracondylar fracture of humerus in children.Methods A total of 183 children with supracondylar fracture of humerus admitted to the Department of Pediatric Orthopedics of this hospital from September 2018 to May 2020 were selected,including 101 males and 82 females.Their ages ranged from 1 to 13 years,with an average age of(7.32±4.38)years.BMI ranged from 18.71 to 22.54 kg/m 2,with an average of(20.37±1.08)kg/m 2.All the children underwent emergency closed reduction Kirschner needle fixation.The number of Kirschner needles ranged from 3 to 4,with an average of(3.32±0.18).Diameter ranged from 1.5 to 2.0 mm,average(1.63±0.90)mm.According to different nursing methods,they were divided into the hydrogel group(using hydrogel to nail the way nursing,81 cases)and the control group(using conventional method to nail the way nursing,102 cases).The score of Visual Analogue Scale,healing of nail,superficial and deep infection,infection strains and so on were recorded in the two groups.Results In the hydrogel group,the score of Visual Analogue Scale and the infection rate of superficial and deep nails were significantly lower than those in the control group at week one to four,and the healing rate of grade A and C were significantly higher than those in the control group,with statistical significance(P<0.05).There was no significant difference in grade B healing rate between the two groups(P>0.05).The types of bacteria from deep infection were the same as those from superficial infection in the two groups.Conclusion In children with supracondylar fracture of humerus,the use of hydrogel in the nailing nursing can improve the healing degree of the nailing,and then reduce the nailing pain and bacterial infection,especially the incidence of deep infection.It has the advantages of high efficiency,simple operation and safety.

关 键 词：儿童 肱骨髁上骨折 水凝胶 钉道护理 治疗结果 

分 类 号：R473.6[医药卫生—护理学] R726.8[医药卫生—临床医学]