循证护理干预对行桥式皮瓣移植术手外伤患者皮瓣成活率及手部功能恢复情况的影响(1)
[摘要]目的：探讨循证护理干预对行桥式皮瓣移植术的手外伤患者皮瓣成活率及手部功能恢复情况的影响。方法：以2017年3月-2019年3月笔者医院行桥式皮瓣移植术的52例手外伤患者为研究对象。随机将其分为常规组(26例)和研究組(26例)。其中常规组实施常规护理，研究组实施循证护理干预，两组均连续护理4周。比较两组护理后的皮瓣成活率及血管危象发生率、断蒂时间、手部功能恢复优良情况以及生活质量评分。结果：护理后，研究组皮瓣成活率为100.00%，显著高于常规组的76.92%，动脉血管危象发生率为3.85%，显著低于常规组的30.77%，差异均有统计学意义(P<0.05)。研究组断蒂时间显著短于常规组，断蒂后手部功能恢复优良时间<3d的患者比例显著高于常规组，差异有统计学意义(P<0.05)。研究组手部功能恢复优良率为96.15%，高于常规组的69.23%，差异有统计学意义(P<0.05)。研究组生活质量各维度评分均显著高于常规组，差异均有统计学意义(P<0.05)。结论：循证护理干预能够显著提高行桥式皮瓣移植术的手外伤患者的皮瓣成活率，降低血管危象发生率，并能显著缩短功能恢复时间，提高患者生活质量，值得临床进一步研究推广使用。
[关键词]循证护理;桥式皮瓣移植术;手外伤;功能恢复时间;皮瓣成活率;血管危象
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2020)12-0169-03
Effect of Evidence-based Nursing Intervention on Flap Survival Rate and Hand Function Recovery in Patients with Hand Injury undergoing Bridge Flap Transplantation
WANG Kai1，LI Fu-rong1，ZHANG Xin-yan2
(1.Department of Osteoarticular;2.Department of Clinical Psychology，Qingdao Municipal Hospital，Qingdao 266071，Shandong，China)
Abstract： Objective To explore the effect of evidence-based nursing intervention on the survival rate of flap and the recovery of hand function after pedicled surgery in patients with hand injury after bridge flap transplantation. Methods 52 patients with hand injury who underwent bridge flap transplantation in our hospital were selected as the research objects between March 2017 and March 2019. They were divided into the regular group (26 cases) and the research group (26 cases) by random number table method. The regular group received routine nursing， and the research group implemented evidence-based nursing intervention. Both groups were continuously cared for 4 weeks. The survival rate of flap， the incidence of vascular crisis， the time of pedicle fracture， the excellent recovery of hand function and the quality of life score were compared between the two groups. Results After nursing， the survival rate of flap in the research group was 100.00%， significantly higher than that of the regular group (76.92%)， the incidence of arterial crisis in the research group was 3.85%， significantly lower than that in the regular group (30.77%)， the differences were statistically significant (P<0.05). The pedicle cutting time of the research group was significantly shorter than that of the regular group (P<0.05). The proportion of patients with excellent recovery time of hand function less than 3 days after pedicle amputation of the research group was significantly higher than that of the regular group (P<0.05). The excellent and good rate of hand function recovery in the research group was 96.15%， which was higher than that in the regular group (69.23%， P<0.05). The scores of quality of life in the research group were significantly higher than those in the regular group (P<0.05). Conclusion Evidence-based nursing intervention can significantly improve the survival rate of flap in patients with hand injury after bypass grafting， reduce the incidence of vascular crisis， and shorten the functional recovery time and improve the quality of life of patients. It is worthy of further clinical research and application., 百拇医药(王凯 李芙蓉 张新颜)
[关键词]循证护理;桥式皮瓣移植术;手外伤;功能恢复时间;皮瓣成活率;血管危象
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2020)12-0169-03
Effect of Evidence-based Nursing Intervention on Flap Survival Rate and Hand Function Recovery in Patients with Hand Injury undergoing Bridge Flap Transplantation
WANG Kai1，LI Fu-rong1，ZHANG Xin-yan2
(1.Department of Osteoarticular;2.Department of Clinical Psychology，Qingdao Municipal Hospital，Qingdao 266071，Shandong，China)
Abstract： Objective To explore the effect of evidence-based nursing intervention on the survival rate of flap and the recovery of hand function after pedicled surgery in patients with hand injury after bridge flap transplantation. Methods 52 patients with hand injury who underwent bridge flap transplantation in our hospital were selected as the research objects between March 2017 and March 2019. They were divided into the regular group (26 cases) and the research group (26 cases) by random number table method. The regular group received routine nursing， and the research group implemented evidence-based nursing intervention. Both groups were continuously cared for 4 weeks. The survival rate of flap， the incidence of vascular crisis， the time of pedicle fracture， the excellent recovery of hand function and the quality of life score were compared between the two groups. Results After nursing， the survival rate of flap in the research group was 100.00%， significantly higher than that of the regular group (76.92%)， the incidence of arterial crisis in the research group was 3.85%， significantly lower than that in the regular group (30.77%)， the differences were statistically significant (P<0.05). The pedicle cutting time of the research group was significantly shorter than that of the regular group (P<0.05). The proportion of patients with excellent recovery time of hand function less than 3 days after pedicle amputation of the research group was significantly higher than that of the regular group (P<0.05). The excellent and good rate of hand function recovery in the research group was 96.15%， which was higher than that in the regular group (69.23%， P<0.05). The scores of quality of life in the research group were significantly higher than those in the regular group (P<0.05). Conclusion Evidence-based nursing intervention can significantly improve the survival rate of flap in patients with hand injury after bypass grafting， reduce the incidence of vascular crisis， and shorten the functional recovery time and improve the quality of life of patients. It is worthy of further clinical research and application., 百拇医药(王凯 李芙蓉 张新颜)