医护一体化模式治疗手外伤慢性创面的疗效观察

Observation on curative effects of medical and nursing integration mode in treatment of chronic wounds of hand trauma

目的探讨医护一体化模式治疗手外伤慢性创面的临床疗效。方法2015年3月至2020年10月选取海军第九七一医院创面治疗门诊在医护一体化模式下经中西医结合方法治疗的手外伤慢性创面患者576例作为试验组;同期随机抽取医院手外科常规外科治疗的慢性创面患者90例作为对照组,以连续3个月(90 d)为治疗观察期,比较2组患者治疗观察期内的伤口愈合率和手术干预率。随访观察2组患者用药不良反应及手术并发症。结果试验组576例患者中529例愈合,愈合率91.84%,实施手术干预63例,手术干预率10.94%,术后创面全部愈合;对照组90例患者中75例愈合,愈合率83.33%,实施手术干预60例,手术干预率66.67%,术后创面全部愈合。试验组与对照组创面愈合率比较差异无统计学意义(P>0.05)。试验组手术干预率明显低于对照组,差异有统计学意义(P<0.01)。2组患者经观察随访1至3个月,未发现明显用药不良反应及手术并发症。结论医护一体化模式下治疗手外伤慢性创面,临床疗效良好,且手术干预率低。

Objective To explore the clinical effects of integrated medical treatment for chronic hand wounds of hand trauma.Methods A total of 576 patients with chronic hand trauma treated by integrated traditional Chinese and western medicine in the Wound Treatment Outpatient of No.971 Navy Hospital from March 2015 to October 2020,were enrolled as the experiment group,while another 90 patients with chronic wounds treated by routine hand surgery within the same time span in the hospital were randomly selected as the control group.The treatment course of 3 months(90 days)was set as the observation period.The wound healing rate and surgical intervention rate were compared between the patients of the two groups during the observation period.Medical follow⁃ups were made to observe adverse drug reactions and surgical complications in the patients of the two groups.Results Of the 576 patients in the experiment group,529 healed,with a healing rate of 91.84%.63 patients received surgical intervention,with an intervention rate of 10.94%,and all the wound surfaces healed after surgery.Of the 90 patients in the control group,75 healed,with a healing rate of 83.33%,60 patients underwent surgical intervention,with an intervention rate of 66.67%,and after surgery all the wounds healed.There was no statistical significance in the wound healing rate,when comparisons were made between the two groups(P>0.05).The surgical intervention rate of the experimental group was significantly lower than that in the control group,with statistical significance(P<0.01).Medical follow⁃ups were made in the patients of the two groups for a period of 1 to 3 months.No obvious adverse drug reactions and surgical complications were observed in both groups.Conclusion Treatment of chronic wounds of hand trauma under the integrated medical and nursing mode could achieve good clinical effects,with a low rate of surgical intervention.