水胶体敷料衬垫对应用气压止血带患者并发症发生率的影响

Effects of hydrocolloid dressing pad on the incidence rate of complications in patients with air tourniquet

目的探讨水胶体敷料衬垫对应用气压止血带患者并发症发生率的影响。方法随机抽样法选取2015年1月至2016年1月本院300例四肢骨折皮肤损害高危患者,行手术治疗,术中均应用气压止血带。随机数字表法分为对照组和研究组,每组150例。对照组应用普通棉质敷料作为衬垫,研究组应用水胶体敷料作为衬垫。比较2组止血疗效、减压后副损伤发生情况、手术时间、气压止血带使用时间、住院时间及患者术中舒适度、医生对衬垫使用满意度。结果研究组止血优良率高于对照组,差异有统计学意义(P<0.05);研究组减压后副损伤发生率低于对照组,差异有统计学意义(P<0.05);2组手术时间、气压止血带使用时间比较,差异无统计学意义(P>0.05);但研究组住院时间短于对照组,差异有统计学意义(P<0.05);研究组皮肤损害并发症发生率低于对照组,差异有统计学意义(P<0.05);研究组患者术中舒适度评分、医生对衬垫使用满意度评分高于对照组,差异有统计学意义(P<0.05)。结论四肢骨折皮肤损害高危患者术中应用水胶体敷料作为气压止血带衬垫可改善止血效果,减轻减压后副损伤,降低皮肤损害并发症发生率,改善患者舒适度及医生满意度,缩短住院时间。

Objective To investigate the effects of hydrocolloid dressing pad on the incidence rate of complications in patients with air tourniquet.Methods A total of 300 patients with four limb fracture complicated by skin damage who were treated in our hospital from January 2015 to January 2016 were enrolled in the study,who were randomly divided in to control group and research group,with 150 cases in each group.The patients in both groups were treated by surgery,with air tourniquet being used during operation.Moreover the patients in control group were treated by ordinary cotton dressing as pad,however,the patients in research group were treated by hydrocolloid dressing as pad.The hemostasis effects,the incidence of secondary injuries after decompression,operation time,and the use time of pneumatic tourniquet,the length of hospital stay,intraoperative comfort of patients and satisfaction degree of doctors were observed and compared between the two groups.Results The good/excellent rate of hemostasis in research group was 97.33%,which was significantly higher than that(92.00%)in control group(P<0.05).The incidence rate of secondary injury after decompression was 3.33%(5/150)in research group,which was significantly lower than that[9.33%(14/150)]in control group(P<0.05).There were no significant differences in operation time and use time of pneumatic tourniquet between the two groups(P>0.05).However,the length of staying in hospital in research group was significantly shorter than that in control group(P<0.05).The incidence rate of skin lesion complications in research group was 2.67%,which was significantly lower than that(10.00%)in control group(P<0.05).In addition the scores of intraoperative comfort and doctors’satisfaction degree with the pad in research group were significantly higher than those in control group(P<0.05).Conclusion The application of hydrocolloid dressing as a pneumatic tourniquet pad during the operation in patients with four limb fracture complicated by skin damage can improve the hemostasis effects,reduce the secondary injury after decompression,reduce the incidence of skin damage complications,improve the comfort degree of patients and the satisfaction degree of doctors,and shorten the length of hospital stay.