循证护理路径预防游离皮瓣移植术后血管危象的临床效果观察

张伟球

[摘要] 目的 探究循证护理路径预防游离皮瓣移植术后血管危象的临床效果。 方法 选取2015年1月～2016年12月在我院接受皮瓣移植术的患者60例作为研究对象，经伦理委员会同意后随机分为研究组和参照组，每组30例。参照组患者予以常规护理行术后干预，研究组患者予以循证护理行术后干预。比较两组患者护理干预效果。 结果 研究组患者术后血管危象总发生率为3.3%，参照组患者术后血管危象总发生率为23.3%，差异具有统计学意义（P<0.05）。研究组患者的护理总满意度为96.7%，参照组患者的护理总满意度为76.7%，差异具有统计学意义（P<0.05）。 结论 对游离皮瓣移植患者行循证护理效果显著，能够明显降低术后血管危象的发生率，提高患者护理满意度，值得在护理工作中借鉴学习。

[关键词] 循证护理；常规护理；游离皮瓣移植；血管危象

[中图分类号] R473.6 [文献标识码] A [文章编号] 2095-0616（2017）20-146-04

Clinical effect of evidence-based nursing path in preventing the postoperative vascular crisis after free flap transplantation

ZHANG Weiqiu

Chashan Hospital of Dongguan City，Dongguan 523000，China

[Abstract] Objective To study the clinical effect of evidence-based nursing path in preventing the postoperative vascular crisis after free flap transplantation. Methods Sixty patients received skin flap transplantation in our hospital from January 2015 to December 2016 were selected as the study subjects. After the agreement of the ethics committee， they were randomly divided into the study group and the reference group，with 30 cases in each group. The patients in the control group were given the postoperative intervention with conventional care， the patients in the study group were given the postoperative intervention with evidence-based nursing. The effect of nursing intervention were compared between the two groups. Results The total incidence of postoperative vascular crisis in the study group was 3.3%，and the total incidence of vascular crisis was 23.3% in the control group. The total nursing satisfaction of the patients in the study group was 96.7%，and the total satisfaction of the patients in the control group was 76.7%.The difference between the two groups was statistically significant（P<0.05）. Conclusion The evidence-based nursing on patients with free skin flap transplantation have a significant effect，and can significantly reduce the incidence of vascular crisis and improve patient care satisfaction， which is worth learning in nursing.

[Key words] Evidence-based nursing； Conventional nursing； Skin flap transplantation； Vascular crisis

游離皮瓣移植是临床上技术较为成熟的一种医疗手段，其皮瓣的取皮范围广泛，已广泛应用于如皮肤烧伤、切割伤等软组织缺损的修复[1-2]，游离皮瓣移植的主要优点就是皮瓣携带有血管和感觉神经，血运丰富，其抗感染能力强，可供的皮瓣区较为隐蔽，而且与缺损区的皮肤颜色大体一致等，因此游离皮瓣移植给患者带来希望。但游离皮瓣移植术后也有一些不良反应，比较常见的就是术后血管危象发生，引起组织移植皮瓣的部位发生坏死，给患者造成严重的损伤，影响患者健康[3-4]。循证护理是一种科研资料与临床经验相结合，审慎、明智地获取护理证据，为临床中护理工作提供依据[5]。近年来随着护理质量的提升，询证护理在临床中的应用越发广泛，研究发现对游离皮瓣患者行循证护理效果确切。现对我院60例游离皮瓣移植患者进行研究分析，探究循证护理路径预防游离皮瓣移植术后血管危象的临床效果。……