改良型冷疗仪对胫腓骨骨折患者术后肿痛的护理效果

Nursing effect of modified cold therapy instrument on postoperative swelling and pain in patients with tibiofibular fracture

目的探讨改良型冷疗仪对胫腓骨骨折患者术后疼痛及肿胀度的护理效果。方法选取2016年6月至2017年6月常州市肿瘤医院进行手术的胫腓骨骨折患者80例,按照随机数字表法将其分为对照组和试验组,每组40例。对照组患者应用常规冰敷护理,试验组应用改良型冷疗仪进行护理。观察2组患者护理前后患肢疼痛评分数字评分法(NRS)、张力性水疱及皮肤出现皮纹情况、肿胀度及并发症发生情况。结果干预前,2组患者在疼痛评分及肿胀度上比较差异无统计学意义(P>0.05)。护理干预后,2组患者疼痛评分均有所下降,但试验组为(2.2 ± 0.3)分,明显低于对照组的(3.6 ± 0.5)分,差异有统计学意义(t=15.185,P<0.05);试验组患者护理期间张力性水疱发生率、皮肤出现皮纹发生率、中度肿胀度分别为10%(4/40)、77.5%(31/40)、10%(4/40),对照组分别为30%(12/40)、50%(20/40)、27.5%(11/40),2组比较差异有统计学意义(χ2=5.000、6.545、4.021,P<0.05);2组患者均未发生患肢深静脉血栓及骨筋膜室综合征等并发症。结论改良型冷疗仪冷敷较常规冰敷护理效果更好,更能减轻胫腓骨骨折患者肿胀疼痛程度,有利于患者康复,值得临床应用。

Objective To explore the effect of modified cold therapy instrument on postoperative pain and swelling of patients with tibiofibular fracture. Methods Eighty patients with tibia and fibula fracture who underwent surgery in Changzhou Cancer Hospital from June 2016 to June 2017 were selected and divided into control group and experimental group according to random number table method, 40 cases in each group. Patients in the control group were treated with conventional ice care, and the experimental group was treated with a modified cold therapy device. The Numerical Rating Scale (NRS) scores, tension blisters and skin dermatoglyphics, swelling and complications were observed before and after treatment. Results Before the intervention, the difference in pain score and swelling degree between the two groups was not statistically significant (P>0.05). After nursing intervention, the pain scores of the two groups decreased, but the score of the experimental group was 2.2 ± 0.3, which was significantly lower than that of the control group (3.6 ± 0.5)(t= 15.185, P < 0.05);the incidence of tension blisters, the incidence of dermatoglyph and moderate swelling in the experimental group were 10%(4/40), 77.5%(31/40), 10%(4/40), which were lower than 30%(12/40), higher than 50%(20/20), less than 27.5%(11/40) of the control group (χ2= 5.000, 6.545, 4.021, P<0.05);no complications such as deep vein thrombosis and compartment syndrome were found in both groups. Conclusion The improved cold therapy device cold compress is better than the conventional ice dressing treatment, and can reduce the swelling and pain degree of the patients with tibiofibular fracture, which is beneficial to the rehabilitation of the patient and is worthy of clinical application.