张华娟 吕爱琳 符玉荣

[摘要]目的：探讨个性化护理模式在颅面骨缺损整形修复中的应用价值。方法：选取2016年1月-2018年10月笔者医院收治的颅面骨缺损90例，用计算机随机数字法分为观察组和对照组各45例。对照组患者予以常规护理，观察组患者在对照组基础上予以个性化护理。比较两组患者术后疼痛程度[视觉模拟评分法（Visual analogue scale，VAS）]和护理满意度，观察护理前后负性情绪[焦虑自评量表（Self-rating anxiety scale，SAS）、抑郁自评量表（Self-rating depression scale，SDS）]和生活质量变化情况。结果：观察组患者术后VAS评分低于对照组，护理满意度高于对照组，差异有统计学意义（P<0.05）。两组患者护理后SAS、SDS评分均较护理前降低，且观察组低于对照组，差异有统计学意义（P<0.05）。两组患者躯体功能、心理功能、社会功能、物质生活各维度评分则均较护理前升高，且观察组高于对照组，差异有统计学意义（P<0.05）。结论：在颅面骨缺损整形修复中采取个性化护理模式可有效减轻患者焦虑抑郁等不良情绪和术后疼痛，提高护理质量和满意度，有利于生活质量的提升。

[关键词]个性化护理;颅面骨缺损;整形修复;生活质量;负性情绪

Abstract： Objective  To explore the application value of personalized nursing model in the plastic repair of craniofacial bone defects.  Methods  90 cases of craniofacial bone defects admitted to our hospital from January 2016 to October 2018 were selected and divided into the observation group and the control group according to the computer random number method， with 45 cases in each group. The control group was given routine nursing， and the observation group was given personalized nursing on the basis of control group. The postoperative pain degree [Visual analogue scale （VAS）] and nursing satisfaction were compared between the two groups. The negative emotions [Self-rating anxiety scale （SAS）， Self-rating depression scale （SDS）] and quality of life were observed before and after nursing. Results  The postoperative VAS score in the observation group was lower than that in the control group， and the nursing satisfaction was higher than that in the control group， the differences were statistically significant（P<0.05）. The scores of SAS and SDS in the two groups after nursing were lower than those before nursing， and the scores in the observation group were lower than those in the control group（P<0.05）. The scores of dimensions of physical function， psychological function， social function and material life were higher than those before nursing， and the scores in the observation group were higher than those in the control group（P<0.05）. Conclusion  Personalized nursing model in the plastic repair of craniofacial bone defects can effectively alleviate the negative emotions of anxiety and depression and postoperative pains， improve the nursing quality and satisfaction， and help to improve the quality of life.

Key words： personalized nursing; craniofacial bone defect; plastic repair; quality of life; negative emotion

顱面骨缺损指颅腔密闭性、颅面骨连续性被破坏，可由外伤或脑部手术造成。颅骨小缺损对脑组织生理影响较小，但患者往往存在不明原因头痛、失眠、焦虑、不安全感、多梦等颅骨缺损综合征表现，面骨缺损则对外观有明确影响[1]。颅骨缺损直径大于3cm或合并严重症状影响正常生活者需进行颅面骨缺损修补术，目前常用的修补材料为自体颅骨或数字化塑形钛网[2]。随着人们对生活质量要求逐渐提高，选择整形修复改善外观缺陷的人也逐渐增多，其目的不仅在于恢复功能，更重要的是对外貌的改善或恢复[3]。除先进的计算机辅助计划外，整形修复围术期的护理工作也会对患者恢复情况造成直接影响，因此临床也逐渐重视针对患者病情展开个性化护理[4]。本研究旨在探讨个性化护理模式在颅面骨缺损整形修复中的应用价值，为提高临床护理质量提供科学依据，现报道如下。……