综合阶段性护理干预联合药物治疗对外伤性下肢截肢术后病人短期临床结局的影响

Effect of the comprehensive stage nursing intervention combined with drug therapy on short-term clinical outcomes of patients with traumatic lower limb amputation

目的:探讨综合阶段性护理干预联合牛痘疫苗致炎兔皮提取物、高乌甲素贴片治疗对外伤性下肢截肢术后病人短期临床结局的影响。方法:选择接受治疗的外伤性下肢截肢病人180例,采取随机数字表法将病人分为综合阶段性护理干预联合牛痘疫苗致炎兔皮提取物、高乌甲素贴片治疗组(观察组) 90例和常规护理干预联合牛痘疫苗致炎兔皮提取物、高乌甲素贴片治疗组(对照组) 90例。病人入院时,详细询问并记录其临床资料及损伤数据。比较2组病人在术后30 d McGill疼痛问卷评分、90项症状自评量表评分、简化健康调查简表评分及并发症发生率方面的差异。结果:术后30 d,观察组在术后疼痛指数评分、疼痛模糊评分、疼痛程度评分、90项症状自评量表评分方面均低于对照组(P <0. 05～P <0. 01)。术后30 d,观察组在简化健康调查简表评分的精神健康、活力、社会功能、躯体疼痛、情感职能方面均高于对照组(P <0. 01)。术后30 d内,观察组术后并发症发生率为8. 89%,低于对照组的13. 33%,但差异无统计学意义(P> 0. 05)。结论:相比常规护理干预,综合阶段性护理干预联合牛痘疫苗致炎兔皮提取物、高乌甲素贴片治疗更有利于外伤性下肢截肢术后病人短期临床结局。

Objective： To investigate the effects of the comprehensive stage nursing intervention combined with rabbit skin extract inflamed by vaccinia virus and lappaconitine adhesive patch on the clinical outcomes of patients with traumatic lower limb amputation.Methods： One hundred and eighty patients with traumatic lower limb amputation were divided into the comprehensive stage nursing intervention combined with rabbit skin extract inflamed by vaccinia virus and lappaconitine adhesive patch therapy group（ 90 cases,observation group） and routine nursing intervention combined with rabbit skin extract inflamed by vaccinia virus and lappaconitine adhesive patch therapy group（ 90 cases,control group） according to the random number table method. The clinical and damage data of all patients on admission were obtained. After 30 d of operation,the differences of McGill SF-MPQ score,SCL-90 score,SF-36 score and incidence rate of complications between two groups were compared. Results： After 30 d of operation,the scores of PRI,VAS,PPI and SCL-90 in observation group were significantly lower than those in control group（ P〈0. 05 to P〈0. 01）. After 30 d of operation,the scores of mental health,vitality,somatic pain,social function and emotional function of SF-36 scale in observation group were higher than those in control group（ P〈0. 01）. The difference of the incidence rate of complications between the observation group（ 8. 89%）and control group（ 13. 33%） was not statistically significant（ P〉0. 05）. Conclusions： Compared with the routine nursing intervention,the comprehensive stage nursing intervention combined with rabbit skin extract inflamed by vaccinia virus and lappaconitine adhesive patch therapy is more conducive to improve the short-term clinical outcome of patients with traumatic lower limb amputation.