预见性护理在烧伤整形植皮患者术后恢复中的应用价值研究

陈婉红 潘翠云 张丹

【摘要】 目的：预见性护理在烧伤整形植皮患者术后恢复中的应用价值。方法：选取2016年4月-2017年4月本院收治的86例烧伤整形植皮手术患者为受试对象，按照随机数字表法将其分为研究组与对照组，各43例。对照组给予常规护理，研究组采用预见性护理。比较两组护理期间创面愈合、发热消失、血小板计数恢复正常时间，护理8 d后的植皮后创面覆盖率、皮下血肿个数，护理6个月后瘢痕指数（SCAR量表）及并发症情况。结果：护理期间，研究组创面愈合、发热消失、血小板计数恢复正常时间均明显少于对照组（P<0.05）;护理8 d后，研究组植皮后创面覆盖率明显高于对照组，皮下血肿个数明显少于对照组，差异均有统计学意义（P<0.05）;护理6个月后，研究组SCAR量表得分、并发症发生率均明显低于对照组（P<0.05）。结论：烧伤整形植皮患者术后进行预见性护理，可加快患者痊愈时间、降低并发症的发生风险。

【关键词】 预见性护理; 烧伤整形植皮

【Abstract】 Objective：To explore the application value of predictive nursing in postoperative recovery of patients with burn plastic skin grafting.Method：A total of 86 patients with burn plastic skin grafting from April 2016 to April 2017 in our hospital were selected as subjects.According to the random number table method，they were divided into study group and control group，43 cases in each group.The control group was given routine nursing，while study group was given predictive nursing.The time of wound healing，fever disappearing and platelet count returning to normal during nursing，the wound coverage rate and the number of subcutaneous hematomas after 8 days of nursing，scar index（SCAR）and complications after 6 months of nursing between two groups were compared.Result：During nursing，the time of wound healing，fever disappearing and platelet count returning to normal in study group were significantly shorter than those of control group（P<0.05）.After 8 days of nursing，the wound coverage rate of study group was significantly higher than that of control group，the number of subcutaneous hematoma was significantly less than that of control group，the differences were statistically significant（P<0.05）.After 6 months of nursing，the SCAR score and the incidence of complications in study group were significantly lower than those of control group（P<0.05）.Conclusion：Predictive nursing for patients with burn plastic skin grafting can speed up the recovery time and reduce the risk of complications.

【Key words】 Predictive nursing; Burn plastic skin grafting

First-authors address：The Fifth Affiliated（Zhuhai）Hospital of Zunyi Medical College，Zhuhai 519100，China

doi：10.3969/j.issn.1674-4985.2019.08.026

通过热液（水、油等）、蒸汽、火焰、高温气体、融化的金属液体或固体（钢水等）引起的皮肤、黏膜组织损伤称为烧伤[1]。当患者大面积烧伤时，机体失去皮肤屏障的保护，皮肤渗出液增多，蒸发大量水分，血液循环下降，容易出现休克等症状。对于大面积烧伤的患者来说，需要进行植皮手术，取患者自身健康处皮肤，覆盖烧伤、瘢痕区域[2]。植皮手术中移植的皮肤较薄，血管容易造成堵塞;进行面部植皮的患者移植皮肤容易皱而隆起，使患者出现不能合眼、合嘴，流口水等现象[3]。预见性护理是针对患者在治疗过程中可能出现的不良反应，提前制定好预防及护理措施，避免或减少患者并发症发生的一种有效的护理干预方案。故本研究将烧伤整形植皮患者作为研究對象，术后进行预见性护理，以利用其预见性的准备护理或措施的优势，使患者预后更好，现报道如下。……