游离肌瓣移植联合植皮术修复四肢外伤性缺损患者的临床护理(1)
[摘要]目的：研究游离肌瓣移植联合植皮术修复四肢外伤性缺损患者的临床护理路径。方法：纳入笔者医院接受游离肌瓣移植联合植皮术修复四肢外伤性缺损患者176例，按就诊顺序随机分为观察组与对照组。观察组实施针对性临床护理路径，对照组采取常规护理路径。观察两组患者的肌瓣成活情况、创面复原时间、疼痛程度、住院时间、肌力水平与运动功能积分(Fugl-Meyer，FMA)数据。结果：观察组患者的创口复原时间、疼痛程度与皮瓣成活率均优于对照组，差异有统计学意义(P<0.05)；观察组患者住院时间、肌力水平与FMA评分均优于对照组，差异有统计学意义(P<0.05)。结论：对游离肌瓣移植联合植皮术修复四肢外伤性缺损患者采取针对性临床护理路径能够优化患者的术后康复效果。
[关键词]游离肌瓣移植；植皮术；四肢外伤性缺损；临床护理路径
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2018)05-0141-04
, 百拇医药
Clinical Nursing of Patients with Traumatic Defect of Extremities Repaired by Free Muscle Flap Combined with Skin Graft
GAO Hua1，SHANG Xiao-fen2，LIN Yuan-yuan3
(1.Department of Burn and Plastic Surgery；2.Department of Otorhinolaryngology；3.Ophthalmology Outpatient，Qingdao Municipal Hospital，Qingdao 266000，Shandong，China)
Abstract： Objective To study the clinical nursing of patients with traumatic defect of extremities by free muscle flap transplantation combined with skin grafting. Methods 176 cases of extremities traumatic defect were repaired by free muscle flap transplantation and skin grafting in our hospital. The patients were randomly divided into the observation group and the control group according to the order of treatment. The observation group carried out the targeted clinical nursing path and the control group took the routine nursing path. The survival of the muscle flap， the time of wound healing， the degree of pain， the time of hospitalization， the level of muscle strength and the Fugl-Meyer (FMA) data were observed in the two groups. Results The wound healing time， pain degree and skin flap survival rate of the observation group were better than those of the control group， the differences were statistically significant(P<0.05). The hospitalization time， muscle strength level and FMA score of the observation group were better than those of the control group(P<0.05). Conclusion The clinical nursing pathway of targeted free muscle flap transplantation combined with skin grafting to repair limb traumatic defects can optimize the postoperative rehabilitation effect of patients.
, 百拇医药
Key words： free muscle flap transplantation； skin grafting； limb traumatic defect； clinical nursing pathway
四肢外伤性缺损患者通常出現骨骼、肌腱等重要组织器官的外露或缺损，一旦处理不及时或处理不当极易导致患者截肢或为患者带来严重的功能性障碍，对患者的日常生活及生理心理带来严重影响。游离肌瓣移植可通过取位置较深，损伤中保存较好的肌肉组织进行创面修复，从而实现对组织缺损的良好修补[1-3]。在此基础上使用将健康皮肤移植到病灶部分的植皮术可实现对表面皮肤的修复，从而实现内部组织与表层皮肤同时修补的效果，使患者获得更佳的治疗效果。但该种联合治疗方式不仅对施术者的技术水平要求较高，对护理人员的护理质量也有较高要求，良好的护理措施配合优质手术条件可获得满意疗效[4-6]。本文通过对笔者医院176例游离肌瓣移植联合植皮术修复四肢外伤性缺损患者实施不同护理干预来探索针对性临床护理路径对该类患者疾病康复的辅助效果，现报道如下。, http://www.100md.com(高华 商晓芬 蔺媛媛)
[关键词]游离肌瓣移植；植皮术；四肢外伤性缺损；临床护理路径
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2018)05-0141-04
, 百拇医药
Clinical Nursing of Patients with Traumatic Defect of Extremities Repaired by Free Muscle Flap Combined with Skin Graft
GAO Hua1，SHANG Xiao-fen2，LIN Yuan-yuan3
(1.Department of Burn and Plastic Surgery；2.Department of Otorhinolaryngology；3.Ophthalmology Outpatient，Qingdao Municipal Hospital，Qingdao 266000，Shandong，China)
Abstract： Objective To study the clinical nursing of patients with traumatic defect of extremities by free muscle flap transplantation combined with skin grafting. Methods 176 cases of extremities traumatic defect were repaired by free muscle flap transplantation and skin grafting in our hospital. The patients were randomly divided into the observation group and the control group according to the order of treatment. The observation group carried out the targeted clinical nursing path and the control group took the routine nursing path. The survival of the muscle flap， the time of wound healing， the degree of pain， the time of hospitalization， the level of muscle strength and the Fugl-Meyer (FMA) data were observed in the two groups. Results The wound healing time， pain degree and skin flap survival rate of the observation group were better than those of the control group， the differences were statistically significant(P<0.05). The hospitalization time， muscle strength level and FMA score of the observation group were better than those of the control group(P<0.05). Conclusion The clinical nursing pathway of targeted free muscle flap transplantation combined with skin grafting to repair limb traumatic defects can optimize the postoperative rehabilitation effect of patients.
, 百拇医药
Key words： free muscle flap transplantation； skin grafting； limb traumatic defect； clinical nursing pathway
四肢外伤性缺损患者通常出現骨骼、肌腱等重要组织器官的外露或缺损，一旦处理不及时或处理不当极易导致患者截肢或为患者带来严重的功能性障碍，对患者的日常生活及生理心理带来严重影响。游离肌瓣移植可通过取位置较深，损伤中保存较好的肌肉组织进行创面修复，从而实现对组织缺损的良好修补[1-3]。在此基础上使用将健康皮肤移植到病灶部分的植皮术可实现对表面皮肤的修复，从而实现内部组织与表层皮肤同时修补的效果，使患者获得更佳的治疗效果。但该种联合治疗方式不仅对施术者的技术水平要求较高，对护理人员的护理质量也有较高要求，良好的护理措施配合优质手术条件可获得满意疗效[4-6]。本文通过对笔者医院176例游离肌瓣移植联合植皮术修复四肢外伤性缺损患者实施不同护理干预来探索针对性临床护理路径对该类患者疾病康复的辅助效果，现报道如下。, http://www.100md.com(高华 商晓芬 蔺媛媛)