序贯康复护理在腹部带蒂皮瓣修复手部软组织缺损中的应用

Application of Sequential Rehabilitation Nursing in Repairing Hand Soft Tissue Defects with Pedicled Abdominal Flaps

目的探讨序贯康复护理在腹部带蒂皮瓣修复手部软组织缺损中的应用效果。方法采用方便抽样法,选取2019年1—12月于无锡市第九人民医院手外科行腹部带蒂皮瓣修复治疗的手部软组织缺损患者71例为研究对象。根据患者入院时间先后顺序将其分为对照组(n=35)和观察组(n=36)。对照组给予腹部带蒂皮瓣修复手部软组织缺损常规康复护理,观察组给予序贯康复护理。比较两组患者移植皮瓣、关节活动和日常生活活动能力恢复情况以及患肢疼痛和舒适度评价。结果观察组患者移植皮瓣受压、扭转、折叠、血运异常发生次数以及患肢疼痛程度低于对照组(P<0.001),肩关节和肘关节主动活动以及穿衣、洗漱、进食和如厕等日常生活活动能力恢复情况优于对照组(P<0.05),舒适度评价高于对照组(P<0.001)。结论序贯康复护理能有效减少移植皮瓣异常,减轻患肢疼痛,改善肩关节和肘关节活动,促进患者日常生活活动能力恢复,提高舒适度,值得临床进一步推广。

Objective To explore the effect of sequential rehabilitation nursing in repairing hand soft tissue defects with pedicled abdominal flaps.Methods A total of 71 patients with hand soft tissue defects who were repaired with pedicled abdominal flaps in the Department of Hand Surgery of Ninth People's Hospital of Wuxi from January to December 2019 were selected as subjects by convenience sampling.The patients were divided into the control group(n=35)and the observation group(n=36)according to the order of admission time.The control group was given routine rehabilitation nursing for repairing hand soft tissue defects with pedicled abdominal flaps,while the observation group was given sequential rehabilitation nursing.The recovery of transplanted flaps,joint motion and activities of daily living,and limb pain and comfort evaluation were compared between the two groups.Results The frequency of flap compression,torsion,folding,abnormal blood supply and the degree of limb pain in the observation group were lower than those in the control group(P<0.001).The recovery of active shoulder joint and elbow joint motions and the activities of daily living(dressing,washing,eating and toileting)in the observation group was superior to that in the control group(P<0.05).The comfort evaluation in the observation group was better than that in the control group(P<0.001).Conclusion Sequential rehabilitation nursing can effectively reduce abnormal transplanted flaps and limb pain,improve shoulder joint and elbow joint motions,promote the recovery of patients'activities of daily living and increase the comfort level.Thus,it is worthy of further clinical promotion.