腓肠神经营养皮瓣术后肝素置管治疗儿童足跟部损伤的观察和护理

CLINICAL EFFICACY OF HEPARIN CATHETER AFTER SURAL-NERVE NUTRIENT FLAP IN THE TREATMENT OF CHILDREN HEEL INJURIES AND ITS NURSING

目的观察与探讨腓肠神经营养皮瓣术后肝素置管治疗儿童足跟部损伤的护理。方法选择2015年1月-2017年1月在该科住院治疗的88例严重足踝部组织缺损伴骨外露的患儿,按照随机数字表法分为对照组和观察组,每组44例。对照组采用常规的护理方法,观察组则在术后经小隐静脉断端留置套管针,通过留置套管针静脉注射肝素,令肝素直接部分作用在皮瓣组织上,并给予相应的护理方法。结果观察组有4例发生皮瓣边缘局部坏死,经换药治疗后愈合,其余40例病情稳定,无异常情况。对照组患儿仅有20例病情稳定,其余24例均有不同程度的复发现象。结论腓肠神经营养皮瓣术后肝素置管治疗儿童足跟部损伤可提高腓肠神经营养皮瓣的成活率,有效降低患儿血管危象的发生几率,提高手术的成功率。

Objective To observe and discuss the nursing applied when treating children heel injuries with heparin catheter after sural- nerve nutrient flap operation. Methods Totally 88 children suffering from se- rious heel tissue defect with bone exposure hospitalized in author＇s department from January 2015 to January 2017 were selected as subjects and divided into control group and observational group according to random number table, 44 for each group. The regular nursing method was provided to patients in control group while for those in observational group, catheter needles were left on their broken ends of small saphenous vein after operation, by which the heparin was injected to vein to make it directly work on flap tissues, and the corresponding nursing methods were offered. Results Local necrosis occurred in flap verges of 4 pa- tients in observational group and healed up after dressing- change treatment. The conditions of the rest 40 patients were stable, without any abnormal conditions. Only 20 patients in control group had stable condi- tions, the rest 24 had recurrences at different levels. Conclusions Treating children heel injuries with hep- arin catheter after sural- nerve nutrient flap operation is able to increase the survival rate of sural - nerve nutrient flap, effectively reduce the occurrence rate of vessel crisis and to increase the yield ratio of operation.