快速康复外科护理对断指再植术后手指功能恢复的影响

Effect of fast track surgery nursing on finger function recovery after replantation of severed fingers

目的探讨快速康复外科护理对断指再植术后手指功能恢复的影响。方法选取2018年6月-2019年6月靖江市人民医院行断指再植术的患者68例,依据随机数字表法分两组,对照组34例,行常规护理;观察组34例,行快速康复外科护理。比较两组患者血管危象形成率、断指再植成活率,断指功能恢复优良率、住院时间、舒适度和疼痛程度。结果观察组断指再植术后血管危象形成率为11.76%,显著低于对照组的35.29%(P<0.05);断指再植成活率为91.18%,显著高于对照组的67.65%(P<0.05)。观察组断指功能恢复优良率为94.12%,显著高于对照组的70.59%(P<0.05),观察组住院时间显著短于对照组(P<0.05)。干预后,两组Kolcaba舒适状况表(GCQ)评分均显著高于干预前(P值均<0.05),视觉模拟评分法(VAS)评分均显著低于干预前(P值均<0.05),且观察组GCQ评分显著高于对照组(P<0.05),VAS评分显著低于对照组(P<0.05)。结论快速康复外科护理能显著降低断指再植术后血管危象形成率和疼痛感,提高断指再植成活率、断指功能恢复优良率和患者舒适度,使患者尽早出院。

Objective To explore the effect of fast track surgery nursing on finger functionrecovery after replantation.Methods From June 2018 to June 2019,68 patients undergoingsevered finger replantation in Jingjiang People's Hospital were selected,and randomly divided intotwo groups.The control group(n=34)received routine nursing,and the observation group(n=34)received fast track surgery nursing.The incidence of vascular crisis,survival rate ofreplantation,excellent and good rate of finger function recovery,length of hospital stay,degree ofcomfort and pain were compared between the two groups.ResultsThe incidence of vascularcrisis in the observation group was 11.76%,lower than 35.29%in the control group(P<0.05),and the survival rate of replantation was 91.18%,higher than 67.65%in the controlgroup(P<0.05).The excellent and good rate of finger function recovery in the observationgroup was 94.12%,which was higher than 70.59%in the control group(P<0.05),and thelength of hospital stay in the observation group was shorter than that in the control group(P<0.05).After the intervention,the Kolcaba General Comfort Questionnaire(GcQ)score of the two groups was higher than that before the intervention(both P<0.05).The visual analoguescale(VAS)score was lower than that before the intervention(both P<0.05).The GCQ scoreof the observation group was higher than that of the control group(P<0.05),and the VAS scorewas lower than that of the control group(P<0.05).Conclusion Fast track surgery nursing cansignificantly reduce the incidence of vascular crisis and pain after finger replantation,improve the survival rate of finger replantation,excellent and good rate of finger function recovery and comfortof patients,and help patients to be discharged as soon as possible.