下肢换药支架的设计与应用

Design and application of lower limb dressing change stent

目的：设计下肢换药支架用于减轻下肢创伤患者换药时的痛苦，减少换药时人员配置，增加操作者及患者在换药时的舒适性。方法下肢换药支架用不锈钢管等焊接装配而成，在临床应用中，将56例患者随机分为两组，每组28例。实验组患者换药时使用下肢换药支架，对照组不使用下肢换药支架。观察两组患者舒适性、焦虑自评量表（ SAS）、视觉模拟疼痛评分的差异。结果实验组患者换药时舒适性评价为很好、好、一般的占85.7％，评价不好但能忍受、非常不好的占14.3％；对照组评价为很好、好、一般占32.1％；评价不好但能忍受、非常不好的占67.9％；两组比较差异有统计学意义（ Z＝－3.98， P〈0.05）。术后7 d实验组患者SAS评分为（44.36±15.94）分，对照组为（53.50±15.37）分，差异有统计学意义（t＝－2.184，P〈0.05）。术后2 d和5 d实验组患者疼痛视觉模拟评分分别为（6.75±1.43），（4.60±1.16）分，均低于对照组，差异有统计学意义（t值分别为3.90，3.28；P〈0.01）。结论下肢换药支架设计结构简单，价格便宜，换药时能减轻患者疼痛及心理负担，增加舒适性，值得在骨科临床中推广应用。

Objective To alleviate the pain of patients with lower extremity trauma at dressing change, reduce staffing and increase the comfort of the operator and patient during dressing changes with design of lower limb dressing change stent. Methods Lower limb dressing change stent was made by welding and assembling with stainless steel tubes. In the clinical study, a total of 56 patients were divided into experimental group （ using lower limb dressing change stent） and control group （not using lower limb dressing change stent）, 28 cases respectively. Patients′comfort, self-evaluation of anxiety scale （ SAS） , visual analogue scale （ VAS） pain score were compared between two groups. Results 85. 7% of patients in experimental group and 32. 1% patients in control group gave very good, good and general answers during comfortable evaluation. 14. 3% patients in experimental group and 67.9% patients in control group considered that dressing changes were bad but tolerable or very bad. The difference between two groups was statistically significant （ Z=-3.98, P〈0.05） . Self-evaluation of anxiety scale score （ SAS） on postoperative day 7 in experimental group and control group were （ 44. 36 ± 15. 94） and （53.50±15.37）, the difference was statistically significant （t=-2.184, P〈0.05）. Visual analogue scale pain score （VAS） on postoperative day 2 and 5 in experimental group were （6.75±1.43） and （4.60± 1. 16） and lower than those in control group, the differences were statistically significant （ t=3. 90, 3. 28, P〈0. 01） . Conclusions The lower limb dressing tent has advantages of simple structure, low cost, and could reduce the pain and psychological burden of patients, increase comfort during dressing changes and is worth popularization and application in clinical orthopedics.