基于改良早期预警评分的预见性护理结合皮瓣按摩法对围术期皮瓣的疗效分析

Analysis of the therapeutic efficacy of predictive nursing combined with skin flap massage based on modified early warning score on perioperative skin flap

目的探讨基于改良早期预警评分(MEWS)的预见性护理结合皮瓣按摩法对围术期皮瓣的疗效。方法选取2022年9月至2023年9月在清远市人民医院骨科三区行皮瓣移植手术治疗的患者98例,采用随机数表法将其分为对照组(n=49)和观察组(n=49)。对照组行预见性护理,观察组在对照组基础上予以基于MEWS的预见性护理结合皮瓣按摩法,两组均干预7 d。比较两组皮瓣成活率、术后各皮瓣体征评分、血管危象发生率、并发症发生率以及满意度情况。结果观察组患者皮瓣成活率为93.88%,高于对照组的75.51%,差异有统计学意义(P<0.05);术后7 d,观察组患者疼痛数字评定量表(NRS)评分以及各皮瓣体征评分均低于对照组,差异有统计学意义(P<0.05);观察组患者术后血管危象发生率为6.12%,低于对照组的24.49%,差异有统计学意义(P<0.05);观察组患者并发症总发生率为6.12%,低于对照组的20.41%,差异有统计学意义(P<0.05);术后7 d,观察组术后舒适度各指标评分均高于对照组,差异有统计学意义(P<0.05);观察组总满意度为93.88%,高于对照组的77.55%,差异有统计学意义(P<0.05)。结论基于改良MEWS的预见性护理结合皮瓣按摩法可提高皮瓣成活率,降低血管危象及术后并发症发生率,提升患者舒适度以及护理满意度。

Objective To investigate the therapeutic efficacy of predictive nursing combined with skin flap massage based on modified early warning score(MEWS)on perioperative skin flap.Methods A total of 98 patients who underwent surgical treatment of skin flap transplantation in the DepartmentⅢof Orthopedics of Qingyuan People’s Hospital from September 2022 to September 2023 were selected,and they were divided into the control group(n=49)and the observation group(n=49)according to the random number table method.The control group was treated with predictive nursing,while the observation group was treated with predictive nursing combined with skin flap massage based on modified MEWS on the basis of the control group.Both groups were intervened for 7 days.The survival rate of skin flaps,the scores of postoperative sign of each skin flap,the incidence of vascular crisis,the incidence of complications and the satisfaction of the two groups were compared.Results The survival rate of skin flap in patients of the observation group was 93.88%,higher than 75.51%in patients of the control group,with statistically significant difference(P<0.05).On the 7th day after operation,the scores of pain numerical rating scale(NRS)and scores of each skin flap sign in the observation group were all lower than those in the control group,with statistically significant differences(P<0.05).The incidence of postoperative vascular crisis in the observation group was 6.12%,lower than 24.49%in the control group,with statistically significant difference(P<0.05).The total incidence of complications in the observation group was 6.12%,lower than 20.41%in the control group,with statistically significant difference(P<0.05).On the 7th day after operation,each comfort degree index score of the observation group was all higher than that of the control group,with statistically significant difference(P<0.05).The overall satisfaction of the observation group was 93.88%,higher than 77.55%of the control group,with statistically significant difference(P<0.05).Conclusion Predictive nursing combined with skin flap massage based on improved MEWS can increase the survival rate of skin flap,reduce the incidence of vascular crisis and postoperative complications,upgrade patients’comfort degree and nursing satisfaction.