护理程序对断指再植患者术后环境干预的研究

Study of the environmental interventions by nursing process for patienta after finger replantation

目的探讨断指再植术后科学设置环境条件的护理模式。方法选取2005年6月～2009年5月在我院行断指再植术患者741例为研究对象,2005年6月～2007年5月的356例对照组,按传统显微外科护理模式管理术后环境条件,即常规观察再植指末梢血运,持续烤灯照射,开展病室通风、禁烟等健康教育;2007年6月～2009年5月385例为观察组,按护理程序对其术后的环境条件进行护理干预,包括有效镇痛,绝对卧床,严密观察,禁烟、肢体位置及病室温、湿度管理,预防便秘,心理疏导,功能锻炼,出院指导共计八方面措施;运用SPSS 10.0统计软件统计分析两组患者的血管危象发生情况及总的再植成活率。结果观察组总再植598指,动脉危象发生率18.26%、静脉危象发生率23.03%、总成活率86.80%;对照组总再植603指,动脉危象发生率24.92%、静脉危象发生率31.15%、总成活率78.36%。经统计分析,两组比较差异有显著意义(P<0.05)。结论断指再植术后良好的环境条件设置,可有效改善发生血管危象的环境因素,改善再植指的血液循环,提高断指再植成活率。

Objective To study the replantation of severed fingers to set the environmental conditions of scientific models of care. Method Patients with finger replantation was selected and divided into two groups. One group was the control group according to traditional model of micro-management of postoperative surgical nursing environment, the peripheral blood circulation of the fingers, continuous roast light irradiation, ventilated smoking rooms and other health education was conducted and observed. Another group was experimental group with postoperative nursing process in accordance with environmental nursing intervention, Including effective analgesic, absolute bed rest, close observation, no Smoking, physical location and sick room temperature and humidity control, prevent constipation, psychological counseling, functional training, discharge guidance etc. Data was analyzed by SPSS 12.0 statistical software. Result The total number of finger replantation was 598 in observation group, rate of arterial crisis incidence was 18.26%, incidence of venous crisis was 23.03%. The total survival rate was 86.8% ; there was 603 cases of finger replantation in control group, arterial crisis was 24.92%, 31.15% of intravenous crisis, and total survival rate was 78.36%. There was significant difference between the two groups （P〈0.05）. Conclusion The setting of good environmental conditions is effective in reducing the causes of vascular crisis and improve finger blood circulation and enhance the survival rate of finger replantation.