赖春风 张艳

【摘要】 目的：觀察自制式弹力绷带对重度水肿患者股静脉拔管后渗出的干预效果，以指导未来重度水肿患者合理的穿刺点护理。方法：选择本院2018年7月-2019年7月收治的60例肾病综合征重度水肿患者作为研究对象，采用随机数表法分为两组，各30例。对照组采用传统胶布棉垫加压固定穿刺点，干预组采用自制式弹力绷带加压固定穿刺点。采用本院自制量表评估患者舒适度及治疗依从性，记录并比较两组住院时间、医疗费用、干预期间并发症（渗液、皮肤过敏、皮肤破损、皮下血肿、穿刺点感染）发生情况。结果：干预组舒适度自评量表评分低于对照组，治疗依从性量表评分高于对照组，差异均有统计学意义（P<0.05）。干预组住院时间短于对照组，医疗费用低于对照组，差异均有统计学意义（P<0.05）。干预组并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论：采用自制式弹力绷带对重症水肿患者股静脉拔管后穿刺点进行加压固定可提高患者舒适度及治疗依从性，更利于缩短患者康复时间、减轻医疗负担，患者并发症发生率显著降低，值得临床推广应用。

【关键词】 重度水肿 自制式弹力绷带 股静脉拔管 渗液 并发症

Application of Self-made Elastic Bandage in Patients with Severe Edema after Extubation of Femoral Vein/LAI Chunfeng， ZHANG Yan. //Medical Innovation of China， 2021， 18（01）： -180

[Abstract] Objective： To observe the intervention effect of self-made elastic bandage on the exudation of femoral vein after extubation in patients with severe edema， to guide the reasonable puncture point care for patients with severe edema in the future. Method：A total of 60 patients with severe edema of nephrotic syndrome who were received in our hospital from July 2018 to July 2019 were selected as the research objects， they were divided into two groups with random number table method， 30 cases in each group. In the control group， the puncture point was fixed by pressure with a traditional rubberized cotton pad， and in the intervention group， the puncture point was fixed by pressure with a self-made elastic bandage. Patients comfort and treatment compliance were evaluated by our self-made scale， the hospitalization time and medical costs， the complications during the intervention （bleed， skin allergy， skin damage， subcutaneous hematoma， puncture-point infection） of the two groups were recorded and compared. Result： The self-assessment scale of the intervention group was lower than that of the control group， and the score of the treatment compliance scale was higher than that of the control group， the differences were statistically significant （P<0.05）. The hospitalization time of the intervention group was shorter than that of the control group， and the medical cost was lower than the control group， the differences were statistically significant （P<0.05）. The incidence of complications in the intervention group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： Using self-made elastic bandage to fix the puncture point of the femoral vein after extubation in patients with severe edema can improve the patients comfort and treatment compliance. It is more conducive to shorten the recovery time of patients and reduce the medical burden. The incidence of complications of patients is significantly reduced， which is worthy of clinical promotion and application.

[Key words] Severe edema Self-made elastic bandage Femoral vein extubation Exudate Complications

First-authors address： First Affiliated Hospital of Gannan Medical College， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.01.043

重度水肿可发生于多种疾病，本研究选取肾病综合征患者为例，探讨自制式弹力绷带对肾病综合征合并重度水肿的护理效果。目前治疗肾病综合征常采用激素疗法，长期实施激素治疗可引发不同程度的并发症，包括全身重度水肿、低蛋白血症、腹腔积液等，治疗风险较高[1]。其中全身重度水肿患者皮肤张力较高，易发生破溃感染，造成疼痛，临床治疗难度较大。单超治疗法（经股静脉置管）是治疗重度水肿的有效手段，可过滤患者体内多余液体，减轻水肿症状，同时能促进治疗药物吸收[2]。但文献[3]指出，置管属于创伤性操作，拔管后患者可出现穿刺点渗液，加重创口感染风险，可延迟创口愈合。……