腓肠神经营养血管筋膜瓣治疗陈旧性跟腱损伤的护理体会

Sural Neurovascular Fascial Flap for Old Achilles Tendon Injury:Experience in Nursing Care

目的研究腓肠神经营养血管筋膜瓣治疗陈旧性跟腱损伤的护理体会。方法将62例陈旧性跟腱损伤患者按随机数字表法分为观察组和对照组,每组31例。2组患者均采用切取腓肠神经营养血管筋膜瓣,将其覆盖在跟腱损伤修补部位的方法进行手术。对照组术后进行常规护理(生命体征、饮食护理及健康教育等);观察组在对照组常规护理的基础上加用舒适护理、康复护理和中医护理等。对患者陈旧性跟腱损伤的主要原因进行分析;采用Armer Lindholm评定标准评价2组患者的疗效,并对2组护理工作的满意率进行比较。结果 62例患者中早期误诊及自愿保守治疗是导致陈旧性跟腱损伤的主要原因,分别占41.94%(26/62)和32.26%(20/62)。观察组优良率为93.55%,对照组优良率为77.41%,2组比较差异有统计学意义(P<0.05);观察组在各项护理(住院环境、护患沟通、护理操作和康复效果)效果方面的满意率均高于对照组(均P<0.05)。结论通过进行及时、有效的护理,可提高腓肠神经营养血管筋膜瓣治疗陈旧性跟腱损伤的临床疗效,提高患者对护理工作的满意度。

Objective To study the nursing care of patients who were treated with sural neurovaseular fascial flap for old achilles tendon injury. Methods Sixty-two patients with old achilles tendon injury were randomly divided into observation group and control group, with 31 patients in each group. All patients were given tendon injury repair with sural neurovascular fascial flap. Patients in control group received routine care （vital signs and diet care and health education）. On the basis of routine care, patients in observation group received comfortable nursing, rehabilitation care and Chinese medical nursing. The main causes of old achilles tendon injury were analyzed. Curative effect was evaluated according to Armer Lindholm criteria. Patient satisfaction with nursing care was compared between the two groups. Results The main causes of old achilles tendon injury were early misdiagnosis and voluntary conservative treatment, accounting for 41.94% （26/62） and 32.26%（20/62）, respectively. The excellent and good rate in observation group was significantly higher than that in control group （93.55% vs 77.41%, P〈0.05）. Compared with control group, patient satisfaction with nursing care （hospital environment,nurse-patient communication,nursing procedure and rehabilitative effect） obv- iously increased in observation group（P〈0.05）. Conclusion Timely and effective care can improve the chnical effect of sural neurovascular fascial flap on satisfaction with nursing care. old achilles tendon injury and increase the patient