吴莉莉　刘慧巧　李静丹

[摘要] 目的 探讨综合性护理对严重开放性颌面耳鼻咽喉头颈复合型外伤效果的影响。 方法 将76例开放性颌面耳鼻咽喉头颈部复合型外伤患者分为观察组和对照组，每组38例。观察组通过综合性护理的方法对患者病情进行评估，判断威胁患者生命的首要因素，采取针对性的救护措施配合医生实施术前抢救。对照组采用常规护理方法。比较两组患者的满意度、康复程度及焦虑抑郁情况。 结果 在疾病康复评分以及生活质量改善评分方面，观察组显著优于对照组（P<0.05）；观察组患者护理满意度评分显著优于对照组（P<0.05）；护理前，两组患者均存在焦虑和抑郁状态，两组患者SAS和SDS无显著性差异（P>0.05），护理后，两组患者的焦虑和抑郁程度均显著改善（P<0.05），观察组患者焦虑和抑郁程度改善更为明显。 结论 综合性护理的方法用于严重开放性颌面耳鼻咽喉头颈部复合型外伤患者的术前病情评估，简单实用，为采取针对性的护理提供了依据。

[关键词] 开放性复合型外伤；颌面耳鼻咽喉头颈外伤；护理

[中图分类号] R473.7 [文献标识码] B [文章编号] 1673-9701（2016）36-0148-04

[Abstract] Objective To explore the method of accurate assessment and nursing of patients with severe complex open maxillofacial otorhinolaryngology head and neck trauma in the high risk period from admission to surgery. Methods A total of 76 cases of complex open maxillofacial otorhinolaryngology head and necktrauma patients were divided into observation group and control group， with 38 patients in each group. The patient's condition was assessed by the comprehensive nursing method in the observation group. The primary factor which threatened the life of the patient was judged， and targeted ambulance measures with the doctor were taken to implement preoperative rescue. And then the control group was given conventional nursing methods.Satisfaction， recovery and anxiety and depression of patients between two groups were compared. Results The rehabilitation score and the quality of life improvement score in the observation group was significantly better than those of the control group（P<0.05）. The nursing satisfaction scores in the observation group were significantly better than those in the control group（P<0.05）. Before nursing， patients in both groups were in the state of anxiety and depression， and SAS and SDS were not significantly different between the two groups（P>0.05）. After nursing， the anxiety and depression of the two groups were significantly improved（P<0.05）. The improvement of anxiety and depression in observation group was more obvious. Conclusion Comprehensive nursing method is simple and practical when used to evaluate the preoperative condition of patients with severe open maxillofacial otorhinolaryngology head and neck trauma， which is simple and practical， and can provide the basis for targeted nursing care.

[Key words] Complex open trauma； Maxillofacial otorhinolaryngology and head and neck trauma； Nursing

處于人体外露突出部位的颌面耳鼻咽喉头颈受伤率很高，其创伤具有复杂性、多样性、高风险性等特点[1]，需要多科学交叉、多技术应用治疗。在临床上，开放性领面耳鼻咽喉头颈部复合型外伤更是一种危重急症[2]。诊断过程中几乎包含了临床医学中整复技术、显微血管技术、微创技术等全部先进技术[3，4]。手术前，患者的病情通常非常复杂，病情恶化较快，甚至有患者在早期并无明显症状，但之后病情恶化迅速，甚至威胁生命[5]。因此，对严重开放性颌面耳鼻咽喉头颈复合型外伤实施正确、有效的护理尤为重要。

1 资料与方法

1.1 一般资料

选取2015年1月～2016年6月我院收治的76例严重开放性颌面耳鼻咽喉头颈复合型外伤患者作为研究对象。……