赫英 褚英

[摘要]目的：探討手部烧伤患者瘢痕整形术后的康复功能锻炼及护理干预。方法：选择笔者医院2016年2月-2017年3月接诊的154例手部烧伤瘢痕整形患者，根据术后康复功能锻炼和护理方法的不同分为观察组和对照组。对照组给予常规功能锻炼指导和护理干预，观察组给予护患共同参与模式的功能锻炼和围手术期精心护理干预。干预后6个月，比较两组患者手部功能临床恢复效果，手部日常生活活动能力和TAM，相关手术指标及外貌恢复满意度。结果：观察组总恢复率为93.51%，明显高于对照组的83.12%，差异具有统计学意义（P<0.05）。干预后，两组患者的吃饭、洗脸、梳头和穿衣活动评分及TAM值均升高，且观察组高于对照组，差异具有统计学意义（P<0.05）。观察组患者住院时间明显少于对照组，且观察组并发症总发生率为2.60%低于对照组的10.39%，差异具有统计学意义（P<0.05）。观察组外貌恢复总满意率为96.11%，明显高于对照组的84.42%，差异具有统计学意义（P<0.05）。结论：手部烧伤后行瘢痕整形术患者围手术期给予精心护理干预和护患共同参与模式的功能锻炼，可恢复手部功能，提高外貌恢复满意度，改善患者生活质量，降低并发症发生率，临床应用价值高。

[关键词]手部烧伤；瘢痕整形；康复功能锻炼；护理干预

[中图分类号]R47 [文献标志码]B [文章编号]1008-6455（2018）06-0138-04

Abstract： Objective To analyze the rehabilitation exercise and nursing intervention for patients with hand burn after scar plastic surgery. Methods 154 cases of scar plastic surgery for hand burn were received in our hospital from February 2016 to March 2017， and the patients were divided into the observation group and the control group according to the postoperative rehabilitation function exercises and nursing methods. The control group was given routine functional exercise guidance and nursing intervention. The observation group was given nurse patient participation in the mode of functional exercise and perioperative intensive nursing intervention. After 6 months of intervention， the effect of hand function recovery， the ability of daily life activity and TAM， related surgical indexes and Appearance recovery satisfaction were compared in the two groups. Results The total recovery rate of the observation group was 93.51%， which was significantly higher than that of the control group （83.12%）， the difference was statistically significant（P<0.05）. After the intervention， the scores of eating， washing， combing and dressing， and TAM of the two groups increased， and the observation group was higher than that of the control group（P<0.05）. The hospitalization time of the observation group was significantly shorter than that of the control group， and the total incidence of complications in the observation group was 2.60%， which was lower than that in the control group（ 10.39%， P<0.05）. The overall satisfaction rate of the observation group was 96.11%， which was significantly higher than that of the control group （84.42%， P<0.05）. Conclusion The patients who underwent scar plastic surgery after hand burn were given careful nursing intervention and functional exercise with the joint participation of nurse and patient， which can restore hand function， improve appearance recovery satisfaction， improve patients' quality of life， reduce the incidence of complications， and have a high clinical value.

Keywords： hand burn； scar plasty； rehabilitation functional exercise； nursing intervention

调查统计显示[1]，手作为人体重要暴露部位，其烧伤在各类烧伤疾病中占据较大比例。手部烧伤遗留瘢痕，不仅可限制患者正常手部功能，还可影响外形美观。临床上对手部烧伤患者遗留瘢痕常采用瘢痕整形术，在功能恢复的同时，实现美容修复，从而提高患者生活质量[2-3]。临床实践显示[4]，手部烧伤瘢痕整形患者的术后效果不仅与手术成功率有关，而且术后的功能锻炼和护理干预方式对手术效果也具有一定影响。常规护理干预和功能锻炼指导，患者依从性差，恢复效果不佳。本文对手部烧伤瘢痕整形患者采用护患共同参与模式的功能锻炼和围手术期精心护理干预，分析患者的恢复效果，旨为手部烧伤瘢痕整形患者的术后恢复提供参考。……