多指挤压旋转撕脱性离断再植患者的围手术期护理

Perioperative Observation and Nursing of Operational Methods on Re-implant of Multi-severed Fingers with Crushed and Rotation Avulsion

目的：总结多指挤压旋转撕脱性离断再植患者围手术期的护理经验，提高护理水平。方法：1997年8月-2005年8月，多指挤压旋转撕脱性离断病人64例，随机分成护理组和对照组各32例。对照组采用常规护理措施，护理组除常规护理外同时应用综合护理程序，即护理评估、诊断、计划、实施及评价等五大步骤。结果：护理组成活27例（84．4％）、焦虑减轻17例（77．3％）、恐惧心理消除8例（80％）、术后一周内未诉患指疼痛30例（93．8％）、围手术期无感染病例：对照组成活22例（68．9％）、焦虑减轻11例（47．8％）、恐惧心理消除4例（44．4％）、术后一周内未诉患指疼痛22例（68．8％）、6例发生感染。两组以上指标经统计学处理存在明显差异（P〈0.01）。结论：多指挤压旋转撕脱性离断病人围手术期内应用护理程序对病人实施整体护理，发现，预防和解决了现存的和潜在的问题，提高了再植体存活率。

Objective： To summarize and elevate the nursing level of severed fingers with crushed and rotation avulsion. Methods： From August 1997 to August 2005, 64 cases of patients were divided into the nursing group and the control group randomly, every group contained 32 cases of patients. In the control group, patients were given routine nursing measures. In the nursing group, patients were given nursing according care program, that was nursing evaluation, nure＇s diagnosis, nursing care plan, practicing, evaluation. Results： In the nursing group, ,about 77.3%（17/22） patients said they felt less anxiety, scare feeling eliminated in 80% patients （8/10）, finger pain occurred in 93.8% （30/32） l w after operation. In the control group, the numbers were only 47.8%（11/23）, 44.4%（4/9）, 68.8%（22/32） （P〈0.01）. There was no infection cases in the nursing group, and the survival rate of re-implant fingers was 84.4% （27/32）. The infection rate of the control group was 18.8% （6/32）, and the survival rate was 68.9% （22/32）, P〈0.01. Conclusion： With care program, patients were given holistic nursing. Discovering, preventing and solving exist or potential problems, then the survival rate of re-implant finger with crushed and rotation avulsion could be raised.