带蒂皮瓣移植修复指端软组织缺损的围术期整体护理

陈斯　梁海　黄晓瑜　吴春珍　谭洁　郑嘉慧　廖海英

【摘要】 目的：评价整体护理应用于带蒂皮瓣移植修复指端软组织缺损围术期内的效果。方法：回顾性分析2015年1月-2018年12月本院收治的82例行带蒂皮瓣移植修复指端软组织缺损手术治疗患者的临床资料，按不同护理措施分为对照组、试验组各41例。对照组应用围术期常规护理，试验组应用围术期整体护理，对比两组患者的疼痛程度、并发症发生率、皮瓣成活率及护理满意度。结果：试验组患者的疼痛程度、并发症发生率均低于对照组，差异均有统计学意义（P<0.05）;试验组患者的皮瓣成活率、护理满意度均高于对照组，差异均有统计学意义（P<0.05）。结论：在带蒂皮瓣移植修复指端软组织缺损手术围术期，实施整体护理措施，不仅可以改善患者疼痛程度、降低并发症发生率，又能提高皮瓣成活率、患者护理满意度，值得临床推广应用。

【关键词】 整体护理; 带蒂皮瓣移植修复; 指端软组织缺损; 围术期; 并发症

【Abstract】 Objective：To evaluate the effect of holistic nursing in the perioperative period of pedicled skin flap transplantation for repairing fingertip soft tissue defect.Method：From January 2015 to December 2018，the clinical data of 82 patients with fingertip soft tissue defect treated by pedicled skin flap transplantation in our hospital were retrospectively analyzed.According to different nursing measures，82 patients were divided into control group and experimental group，41 cases in each group.The control group was given perioperative routine nursing，while the experimental group was given perioperative holistic nursing.The degree of pain，incidence of complications，the survival rate of skin flaps and nursing satisfaction were compared between the two groups.Result：The pain degree and complication rate in the experimental group were lower than those in the control group，there were statistical significance（P<0.05）.The survival rate of skin flaps and nursing satisfaction in the experimental group were higher than those in the control group，there were statistical significance（P<0.05）.Conclusion：In the surgical treatment of fingertip soft tissue defect with pedicled skin flap transplantation，the implementation of holistic nursing measures can not only improve the degree of pain，reduce the incidence of complications，but also improve the survival rate of skin flap and nursing satisfaction，which is worthy of clinical application.

【Key words】 Holistic nursing; Pedicled skin flap transplantation for repair; Fingertip soft tissue defect; Perioperative period; Complication

First-authors address：Shenzhen Longhua District Peoples Hospital，Shenzhen 518109，China

doi：10.3969/j.issn.1674-4985.2019.09.027

指端軟组织缺损属于临床常见病，临床统计表明，手指外伤在我国工伤致残占比较大，也是主要的创伤疾病之一[1-3]。指端软组织缺损不仅会影响手部外观感，还会丧失一部分手功能，给患者身心带来严重的创伤。随着人们生活质量的不断提高，人们对于手部的美感要求越来越高。在指端软组织缺损治疗中，临床多采用残端修整术，虽具有一定的治疗效果，实现修复创面的目的，但创伤修复后，手部的感觉、外观、运动功能、指甲缺乏等均不能令患者满意，尽管医疗水平的不断进步，拇甲瓣移植治疗也会出现较大的创伤，对于手部功能的恢复影响较大[4-6]，故患者接受度较差。随着皮瓣修复技术的进步，带蒂皮瓣移植修复应用于指端软组织缺损治疗中，对修复手部皮肤软组织与恢复手功能具有积极作用[7-9]。如在带蒂皮瓣移植修复指端软组织缺损围术期内，配合整体护理措施，对减少并发症、促使患者病情尽快康复具有积极的临床意义。本次研究针对整体护理应用于带蒂皮瓣移植修复指端软组织缺损的围术期内的效果进行评价，取82例患者开展本次研究，现报道如下。