李颖 谢芳

[摘要]目的：探讨手部深度烧伤后植皮整形治疗及康复路径管理的应用效果。方法：选取本院2015年5月-2017年5月就诊的100例手部深度烧伤患者为研究对象，根据患者入院ID号随机分为对照组和观察组。对照组采取常规治疗，观察组采取植皮整形修复，两组患者均采取康复路径护理管理。比较分析两组患者治疗后的临床疗效、治疗后6个月的功能评分、美观度满意率及术后并发症发生情况。结果：观察组治疗总有效率为96.00%明显高于对照组的84.00%，差异有统计学意义（P<0.05）。观察组总体功能评分为（80.62±10.11）分明显高于对照组的（58.11±15.93）分，疼痛程度评分明显低于对照组，差异有统计学意义（P<0.05）。观察组美观度满意率明显高于对照组，且观察组感染、臃肿、植皮坏死、麻木并发症发生率明显低于对照组，差异均有统计学意义（P<0.05）。结论：植皮整形治疗及康复路径管理应用于手部深度烧伤患者，可有效提高其临床疗效，改善手部功能，降低并发症发生，值得临床上推广应用。

[关键词]手部深度燒伤；植皮修复；整形术；康复路径管理；效果；预后

[中图分类号]R622 [文献标志码]B [文章编号]1008-6455（2018）05-0052-03

Management Analysis of Skin Grafting and Rehabilitation Path after Deep

Burn of Hand

LI Ying，XIE Fang

（Department of Rehabilitation Medicine，Huangshi Maternal and Child Health Hospital，Huangshi 435000，Hubei，China）

Abstract： Objective To explore the clinical effect of skin grafting and rehabilitative path management after deep burn of hand. Methods 100 cases of hand deep burn patients admitted to our hospital from May 2015 to May 2017 were selected and randomly divided into the control group and the observation group according to the ID number of the hospital. The control group was treated with routine treatment， and the observation group was treated with skin grafting， the two groups were treated with rehabilitation path management. The curative effect of the two groups of patients after treatment， the function score of 6 months after treatment， the satisfaction rate to the beauty and the postoperative complications were compared and analyzed. Results The total effective rate of treatment in the observation group （96.00%） was significantly higher than that of the control group （84.00%）， the difference was statistically significant （P<0.05）.The overall functional score in the observation group （80.62±10.11） was significantly higher than that of the control group （58.11±15.93）， and the pain score was significantly lower than that of the control group（P<0.05）. The satisfaction rate of the observation group on the beauty was significantly higher than that of the control group， and the incidence of complications of infection， bloated， skin necrosis and numbness in the observation group were significantly lower than those of the control group （P<0.05）. Conclusion The application of skin plastic surgery and rehabilitation pathway management in patients with deep burn of hand can effectively improve the clinical effect， improve the function of hand and reduce the incidence of complications， which is worthy of clinical promotion and application.

Key words： deep burn of hand； skin grafting； plastic surgery； rehabilitation path management； effect； prognosis

烧伤是临床上常见的皮肤损伤类型，造成烧伤的危险因素有电、热、射线、化学等[1]。手部烧伤在各种烧伤类型中最严重，会引起真皮层损伤，给患者带来剧烈疼痛感，且影响患者手部外观及精细动作。此外，手部烧伤能够形成瘢痕畸形，严重损伤患者的身心健康，给患者的工作和日常生活造成严重影响[2]。临床上对于手部烧伤患者常采取常规治疗，待患者创面结痂后再进行植皮整形，具有一定的疗效，但其带来的术后并发症较多[3]。近年来，医学上相关学者提出对手部深度烧伤患者采取早期植皮整形治疗，疗效明显提高[4]。此外，在患者进行创面修复后的康复治疗是烧伤整体序列治疗的主要部分。近年来，临床路径逐渐被应用于临床护理当中，是一种以循证医学指南和证据作为指导，促进疾病诊疗和管理的方法[5]。……