张美娟 林贝 刘凯明

[摘要]目的：探討改良式简易封闭负压引流技术联合全面护理在断肢再植患者术后创面修复中的应用。方法：选取2018年1月-2020年6月于笔者医院收治的284例断肢再植手术患者作为研究对象，采用单双号法将284例患者随机分为观察组（142例）和对照组（142例）。两组均行断肢再植手术治疗，对照组术后采用常规封闭负压引流技术联合全面护理，观察组采用改良式简单封闭负压引流技术联合全面护理。对比两组创面愈合时间、敷料维持时间、住院时间和住院费用，护理前后疼痛视觉模拟评分（Visual analogue scale，VAS），护理期间的术后并发症发生率以及患者护理满意度。结果：护理后，观察组VAS评分、创面愈合时间、住院时间和住院费用均低于对照组，敷料维持时间高于对照组，差异有统计学意义（P<0.05）。观察组对护理技术、护理态度、护理方式和健康教育方面满意度以及护理总满意度评分均明显高于对照组，差异有统计学意义（P<0.05）。护理期间，观察组并发症发生率3.52%低于对照组的9.86%，差异有统计学意义（P<0.05）。结论：改良式简易封闭负压引流技术联合全面护理在断肢再植患者术后创面修复中的应用，可减少术后并发症的发生，加快创面愈合，并缓解患者疼痛，减少住院时间和费用，提升患者的临床护理满意度。

[关键词]改良式简易封闭负压引流技术;断肢再植手术;全面护理;创面修复;并发症;愈合时间

[中图分类号]R473.6    [文献标志码]B    [文章编号]1008-6455（2021）05-0162-04

Application of Modified Simple Vacuum Sealing Drainage Combined with Comprehensive Nursing in Wound Repair of Patients with Amputated Limb Replantation

ZHANG Mei-juan1，LIN Bei2，LIU Kai-ming3

（1.Trauma Surgery;2.Bone Microsurgery;3.Intensive Care Medicine，Sanya People's Hospital，Sanya 572000，Hainan，China）

Abstract： Objective  to explore the application of modified simple vacuum sealing drainage combined with comprehensive nursing in the wound repair of patients with amputated limb replantation. Methods  A total of 284 patients who underwent severed limb re-plantation and were admitted to the hospital from January 2018 to June 2020 were enrolled as the research objects. They were randomly divide into the observation group （142 cases） and the control group （142 cases） by even-odd number method. Both groups were treated with replantation， the control group was treated with conventional vacuum sealing drainage combined with comprehensive nursing， and the observation group was treated with improved simple vacuum sealing drainage combined with comprehensive nursing. The wound healing time， dressing maintenance time， hospitalization time and cost， scores of visual analogue scale （VAS） before and after nursing， the incidence of postoperative complications during nursing and clinical nursing satisfaction after nursing were compared between the two groups. Results  After nursing， VAS score， wound healing time， hospitalization time and cost in the observation group were all lower than those in the control group， the dressing maintenance time was higher than that of the control group， the differences were statistically significant （P<0.05）. The satisfaction with nursing technology， nursing attitude， nursing methods and health education， and score of total nursing satisfaction in the observation group were significantly higher than those in the control group （P<0.05）. During nursing， incidence of complications in the observation group was lower than that in the control group （3.52% vs 9.86%， P<0.05）. Conclusion  The application of modified simple vacuum sealing drainage combined with comprehensive nursing in the wound repair of patients with replantation of severed limbs can reduce the occurrence of postoperative complications， accelerate wound healing， relieve pain， reduce hospitalization time and cost， and improve the clinical nursing satisfaction of patients.

Key words： modified simple vacuum sealing drainage technology; amputated limb replantation; comprehensive nursing; wound healing; complication; healing time

四肢离断伤是临床骨科较为常见的一种疾病，其治疗的关键在于尽快采取断肢再植术以恢复其血供，并尽量还原其活动能力和功能[1]。近年来，随着医疗技术的不断发展，临床上断肢再植术后的患肢存活率不断提高，但其术后的创面修复不佳仍可造成断肢再植术失败，导致局部组织坏死、截肢等，严重影响患者生活质量生命安全[2]。因此，断肢再植术后采取科学、有效的措施对患者创面进行修复护理尤为重要。负压封闭引流技术（Vacuum sealing drainage，VSD）是已广泛应用于急、慢性创面治疗的一种新技术，主要通过负压引流装置在创面形成负压环境，并负压吸引出创面内的细菌、污染物等以防止创面感染，促使创面尽快愈合[3-4]。……