IMB模型护理在腹部带蒂皮瓣修复术后的应用效果

Application Effect of IMB Model Nursing in Postoperative Abdominal Pedicled Flap Repair

目的:探讨信息-动机-行为技巧(IMB)模型护理在腹部带蒂皮瓣修复术后的应用效果。方法:选取2020年1月—2022年12月柳州市工人医院收治的手部皮肤软组织缺损的60例患者为研究对象。根据随机抽签法将其分为对照组和研究组,各30例。两组均给予腹部带蒂皮瓣修复手术。对照组实施常规护理,研究组在常规护理的基础上实施IMB模型护理。比较两组一期术后2周皮瓣蒂位置情况,二期术后1 d、3 d肩关节外展活动度及肩关节内旋活动度,二期术后1 d、3 d、7 d肩、肘关节功能。结果:研究组皮瓣蒂位置正确率为90.0%(27/30),高于对照组的66.7%(20/30),差异有统计学意义(P<0.05)。二期术后3 d,研究组肩关节外展、肩关节内旋活动度均大于对照组,差异有统计学意义(P<0.05)。二期术后3 d、7 d,研究组Constant-Murley评分、Mayo评分均显著高于对照组,差异有统计学意义(P<0.05)。结论:IMB模型护理能降低腹部带蒂皮瓣修复术患者皮瓣蒂撕脱、折叠、扭转发生率,促进肩肘关节功能恢复。

Objective:To explore the application effect of information-motivation-behavioral skills(IMB)model nursing in postoperative abdominal pedicled flap repair.Method:From January 2020 to December 2022,60 patients with skin and soft tissue defects of hand admitted to Liuzhou Workers'Hospital were selected as the research objects.According to the random drawing method,they were divided into control group and study group,with 30 cases in each group.Both groups were treated with abdominal pedicled flap repair operation.The control group was given routine nursing,and the study group was given IMB model nursing on the basis of routine nursing.The position of the pedicle flap 2 weeks after one stage surgery,the shoulder joint abduction range of motion and the shoulder joint internal rotation range of motion 1 day and 3 days after the second stage surgery,and the shoulder and elbow joint functions 1 day,3 days,and 7 days after the second stage surgery were compared between the two groups.Result:The correct rate of flap pedicle position in the study group was 90.0%(27/30),which was higher than 66.7%(20/30)in the control group,and the difference was statistically significant(P<0.05).At 3 d after the second stage surgery,the range of motion of shoulder joint abduction and shoulder joint internal rotation in the study group were greater than those in the control group,and the differences were statistically significant(P<0.05).The Constant-Murley scores and Mayo scores of the study group were significantly higher than those of the control group at 3 d and 7 d after the second stage surgery,the differences were statistically significant(P<0.05).Conclusion:IMB model nursing can reduce the incidences of avulsion,folding and torsion of pedicle flap in patients undergoing abdominal pedicle flap repair operation,and promote the recovery of shoulder and elbow joint function.