孙巧凤 张丽敏 徐媛媛 陈可佳 周军

[摘要]目的：探究舒适护理在手外伤皮瓣移植术后的应用效果。方法：选取2016年2月-2018年2月在笔者医院手外科行皮瓣移植术的手外伤患者共106例，按随机数字表法将其分为对照组（53例）和舒适护理组（53例）。两组均行皮瓣移植术，对照组给予常规护理，舒适护理组在对照组的基础上给予舒适护理。比较两组患者护理干预后皮瓣存活率、疼痛程度、生活能力和生活质量评分。结果：舒适护理组患者皮瓣存活率为98.11%高于对照组的86.79%，差异有统计学意义（P<0.05）。舒适护理组患者疼痛程度明显轻于对照组，且Barthel指数和QOL评分明显高于对照组，差异有统计学意义（P<0.05）。结论：手外伤皮瓣移植术后行舒适护理干预能有效提升治疗效果，增加皮瓣存活率，减轻术后主观疼痛，改善患者日常生活能力和生活质量，值得临床应用与推广。

[关键词]舒适护理;手外伤;皮瓣移植术;Barthel指数;疼痛;生活质量

[中图分类号]R473.6    [文献标志码]B    [文章编号]1008-6455（2021）03-0153-03

Application Effect of Comfortable Nursing after Hand Trauma Skin Flap Transplantation

SUN Qiao-feng，ZHANG Li-min，XU Yuan-yuan，CHEN Ke-jia，ZHOU Jun

（Department of Medical Examination，Dalian Central Hospital，Dalian 116033，Liaoning，China）

Abstract： Objective  To observe the effect of clinical effect of comfortable nursing after hand trauma skin flap transplantation. Methods  A total of 106 patients with hand trauma who underwent skin flap transplantation in our hospital between February 2016 and February 2018 were selected and divided into the control group （53 cases） and the comfort care group （53 cases） according to the random number table method. Both groups underwent flap transplantation， the control group was given routine care， and the comfort care group was given comfort care based on the control group. The survival rate， pain level， life ability and quality of life of flaps between the two groups after nursing intervention were compared. Results  After nursing， the survival rate of the flaps was 98.11% in the comfort care group， and 86.79% in the control group， the difference was statistically significant （P<0.05）. The degree of pain in the the comfort care group was significantly lighter than that in the control group （P<0.05）. Barthel index and QOL score of the comfort care group were significantly higher than those of the control group （P<0.05）. Conclusion  The comfort care  can increase the survival rate of skin flaps， reduce subjective postoperative pain， and improve the ability and quality of daily life in patients with hand skin flap transplantation after injury， which is worthy for clinical application.

Key words： comfortable nursing; hand trauma; skin flap transplantation; Barthel index; pain; quality of life

手作為人体重要器官之一，常暴露在外，在遇到危险或伤害时，人们常用双手去扶持或遮挡，因此手部外伤是普通外科最为常见的疾病之一[1]。手部软组织缺损常采用皮瓣移植术进行治疗，以尽可能地保持手部的外形和功能，但皮瓣移植术后患者常因皮瓣血管阻塞等原因导致血管危象或皮瓣坏死，故术后护理是保证皮瓣存活的重要措施之一，而选择合适的护理措施显得十分重要[2]。舒适护理是护理人员通过专业知识和技能减少手外伤皮瓣移植术后并发症的发生，缓解不良情绪，减轻疼痛的护理措施[3]。本研究以106例患者为观察对象，探究舒适护理对手外伤皮瓣移植术后患者的皮瓣存活率、疼痛程度和生活质量等的影响，现报道如下。

1  资料和方法

1.1 一般资料：选取2016年2月-2018年2月在笔者医院手外科进行住院治疗的手外伤患者共106例，均行皮瓣移植术。……