应激系统理论下的系统化护理在手部软组织缺损行带蒂皮瓣移植修复患者中的应用

Application of systematic nursing under stress system theory in patients with hand soft tissue defects undergoing pedicled skin flap transplantation and repair

目的探讨应激系统理论下的系统化护理在手部软组织缺损行带蒂皮瓣移植修复患者中的应用。方法选择江苏省宜兴市人民医院2019年7月至2022年12月收治的110例拟行带蒂皮瓣移植修复术治疗的手部软组织缺损患者为研究对象,以随机数字表法将其分为观察组和对照组,各55例。对照组采用系统化护理,观察组在对照组基础上采用基于应激系统理论下的系统化护理,均持续干预至患者出院。比较两组术后恢复情况(皮瓣成活情况、血管危象发生情况、住院时间);比较两组护理前后应激反应[应激反应问卷(SRQ)评分]及创伤后成长水平[创伤后成长量表(PTGI)评分]。结果两组皮瓣成活率、血管危象发生率比较,差异无统计学意义(P>0.05);观察组住院时间短于对照组(P<0.05)。护理后,两组SRQ评分较护理前降低,且观察组低于对照组(P<0.05)。护理后,两组PTGI评分较护理前升高,且观察组高于对照组(P<0.05)。结论手部软组织缺损行带蒂皮瓣移植修复患者采用应激系统理论下的系统化护理可缩短患者住院时间,减轻患者应激反应,改善患者创伤后成长水平。

Objective To explore the application of systematic nursing under stress system theory in patients with hand soft tissue defects undergoing pedicle skin flap transplantation and repair.Methods A total of 110 patients with hand soft tissue defects who were treated with pedicle skin flap transplantation and repair surgery in Yixing People’s Hospital of Jiangsu Province from July 2019 to December 2022 were selected as study subjects.They were divided into control group and observation group,with 55 cases in each group.The control group received systematic nursing,while the observation group received systematic nursing based on stress system theory on the basis of control group.Both continued to intervene until the patient was discharged.The postoperative recovery(occurrence of skin flap survival,occurrence of vascular crisis,and hospitalization time)were compared between the two groups;stress response(stress response questionnaire[SRQ]score),post-traumatic growth level(post-traumatic growth inventory[PTGI]score)before and after nursing were compared between two groups.Results There were no significant differences in the survival rate of skin flap and incidence of vascular crisis between two groups(P>0.05);the hospitalization time of observation group was shorter than that of control group(P<0.05).After nursing,the SRQ scores of both groups were decreased than those before nursing,and that of observation group was decreased than that of control group(P<0.05).After nursing,the PTGI scores were increased than those before nursing,and that of observation group was increased than that of control group(P<0.05).Conclusion Systematic nursing under stress system theory can shorten hospitalization time,reduce the stress response,and improve the post-traumatic growth level of the patients with hand soft tissue defects undergoing pedicled skin flap transplantation and repair.