预见性护理在游离皮瓣修复创伤创面患者中的应用效果

崔永红

【摘 要】目的 探讨对游离皮瓣修复创伤创面患者给予预见性护理的临床效果。方法 选取临夏市人民医院2020年2月-2022年4月收治的60例游离皮瓣修复创伤创面患者作为研究对象，以随机数字表法分为参照组和研究组，每组30例。参照组给予常规护理，研究组给予预见性护理，比较两组血管危象发生率、手术成功率、皮瓣坏死率、皮瓣颜色、皮瓣温度、皮瓣质地评分及疼痛评分。结果 两组手术成功率比较，差异无统计学意义（P>0.05）；研究组血管危象发生率、皮瓣坏死率均低于参照组，差异有统计学意义（P<0.05）；研究组术后72 h皮瓣颜色、皮瓣温度、皮瓣质地及VAS评分均低于参照组，差异有统计学意义（P<0.05）。结论 预见性护理干预在游离皮瓣修复创伤创面患者中的应用效果确切，可有效降低血管危象发生率、皮瓣坏死率，改善患者的皮瓣颜色、皮瓣温度及皮瓣质地，有利于减轻疼痛，促进康复。

【关键词】游离皮瓣；创伤创面；预见性护理；血管危象

中图分类号：R473 文献标识码：A 文章编号：1004-4949（2023）14-0136-04

Application Effect of Predictive Nursing in Patients with Free Flap Repair of Traumatic Wound

CUI Yong-hong

（Department of Surgery， the Peoples Hospital of Linxia， Linxia 731100， Gansu， China）

【Abstract】Objective To explore the clinical effect of predictive nursing for patients with traumatic wounds repaired by free flaps. Methods A total of 60 patients with traumatic wounds repaired by free flaps admitted to the Peoples Hospital of Linxia from February 2020 to April 2022 were selected as the research objects. They were divided into reference group and study group by random number table method， with 30 patients in each group. The reference group was given routine nursing， and the study group was given predictive nursing. The incidence of vascular crisis， surgical success rate， flap necrosis rate， flap color， flap temperature， flap texture score and pain score were compared between the two groups. Results There was no significant difference in the success rate of operation between the two groups （P>0.05）. The incidence of vascular crisis and skin flap necrosis rate in the study group were lower than those in the reference group， the differences were statistically significant （P<0.05）. The flap color， flap temperature， flap texture and VAS score of the study group at 72 h after operation were lower than those of the reference group， the differences were statistically significant （P<0.05）. Conclusion Predictive nursing intervention has a definite application effect in patients with free flap to repair traumatic wounds， which can effectively reduce the incidence of vascular crisis and flap necrosis rate， improve the color， temperature and texture of the flap. Meanwhile， it is conducive to reducing pain and promoting rehabilitation.

【Key words】Free flap； Traumatic wound； Predictive nursing； Vascular crisis

近年來，随着工业化的发展，机械化皮肤损伤发病率逐年增加，包括碾压伤、撕脱伤及砸伤等等，且多为多发伤、复合伤[1，2]。大面积组织缺损常表现为皮肤组织坏死，合并骨、关节、肌腱、血管、神经的损伤和裸露，创面呈现出无法愈合情况，如不及时采用皮瓣覆盖，则深部组织进一步坏死、感染，将严重影响患肢功能，致残率较高[3]。临床治疗面积组织缺损的难度较大，常采用游离皮瓣移植术进行治疗，可修复皮肤缺损，从而加速创面愈合[4，6]。然而，游离皮瓣移植术后患者常出现一系列并发症，对其皮瓣恢复情况产生了不良影响。因此，针对创伤创面患者在游离皮瓣移植术治疗期间，还需配合有效的护理干预，以促进创面愈合，降低感染等并发症发生风险，提高整体治疗效果[7]。常规护理实施期间，护理人员往往因工作繁忙，针对患者的体位、疼痛及心理未给予充分重视，难以获得理想的护理效果。而预……