医护一体化模式对皮肤牵张器闭合胫骨骨折术后皮肤软组织缺损患者的效果评价
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摘要
目的探讨医护一体化模式对皮肤牵张器闭合胫骨骨折术后皮肤软组织缺损患者的效果。方法回顾性分析2016年7月～2017年8月收治的66例胫骨骨折术后皮肤软组织缺损采用皮肤牵张器闭合缺损创面的患者,按实施医护一体化前后分为对照组34例和观察组32例。对照组采用常规医疗护理模式,观察组采用医护一体化模式,比较两组病人住院时间、满意率、并发症发生率以及HSS膝关节功能评分。结果观察组的病人满意率高于对照组,住院时间和并发症发生率低于对照组,差异均有统计学意义(P<0.05)。HSS膝关节功能评分两组无明显差异(P>0.05)。结论皮肤牵张器闭合胫骨骨折术后皮肤软组织缺损患者实施医护一体化护理模式可提高患者满意率,降低住院时间及并发症发生率,在临床推广应用。
Objective To discuss the effect of doctor-nurse integration nursing of skin stretcher applied for recovery of post-operative skin and soft tissue defects in tibia fractures.Methods The data of 66 patient with post-operative skin and soft tissue defects,recovered by skin stretcher in tibia fractures from July 2016 to August 2017 were analyzed,retrospectively.45 cases were divided into control group(34 cases)and observed group(32 cases),according to intervention.Traditional medical care nursing mode was applied in control group,while doctor-nurse integration nursing mode was applied in observed group.The length of hospital stay(LOS),satisfaction degree of patients,complication rate and HSS scores were observed.Results The satisfaction degree of patients in observed group was higher than that in control group,while LOS and complication rate in observed group was lower than that in control group,and the difference was statistically significant(P<0.05).HSS scores were not with significant difference between two groups.Conclusion Doctor-nurse integration nursing of skin stretcher applied for recovery of post-operative skin and soft tissue defects in tibia fractures has positive effect on improving satisfaction degree of patients and decreasing LOS and complication rate,and is worthy of clinical and nursing work.
Objective To discuss the effect of doctor-nurse integration nursing of skin stretcher applied for recovery of post-operative skin and soft tissue defects in tibia fractures.Methods The data of 66 patient with post-operative skin and soft tissue defects,recovered by skin stretcher in tibia fractures from July 2016 to August 2017 were analyzed,retrospectively.45 cases were divided into control group(34 cases)and observed group(32 cases),according to intervention.Traditional medical care nursing mode was applied in control group,while doctor-nurse integration nursing mode was applied in observed group.The length of hospital stay(LOS),satisfaction degree of patients,complication rate and HSS scores were observed.Results The satisfaction degree of patients in observed group was higher than that in control group,while LOS and complication rate in observed group was lower than that in control group,and the difference was statistically significant(P<0.05).HSS scores were not with significant difference between two groups.Conclusion Doctor-nurse integration nursing of skin stretcher applied for recovery of post-operative skin and soft tissue defects in tibia fractures has positive effect on improving satisfaction degree of patients and decreasing LOS and complication rate,and is worthy of clinical and nursing work.
引文
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[19]汤惠英,黄震佳,吴利.一次性注射器用于皮肤扩张器植入术后皮下积液引流效果观察与护理[J].医学美学美容-I临床研究,2015,6:222.
[20]张丽.6l例瘢痕旁和瘢痕下扩张器植入围手术期的护理差异分析[J].齐齐哈尔医学院学报,2015,36(28):4348-4349.
[21]朱金金.26例皮肤软组织扩张器埋植I期围手术期的护理[J].齐齐哈尔医学院学报,2015,6(36):933-934.
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[23]唐胜华,夏冬梅,陆思锭,等.皮肤软组织扩张术后并发症影响因素的探讨[J].中国美容整形外科杂志,2015,1(26):59-61.
[24] Konkel KF,Hussussian CJ.Technique Tip:Avoiding Wound Complications After a Large Opening Wedge Osteotomy of the Distal Tibia Using a Soft-Tissue Expander.Foot Ankle Int.2014,35(6):631-635.
[25] Formby P,Flint J,Gordon WT,et al.Use of a continuous external tissue expander in the conversion of a type IIIB fracture to a type IIIA fracture.Orthopedics.2013,36(2):e249-251.
[2] Gopal S,Majumder S,Batchelor AG,et al.Fix and flap:the radical orthopaedic and plastic treatment of severe open fracture of tibia.J Bone Joint Surg(Br),2000,82(7):959-966.
[3]王叶武,金玉梅,张勇,等.自制硅胶线皮肤牵张技术在皮肤软组织缺损中的临床效果[J].实用骨科杂志,2016,22(11):1048-1050
[4]倪国骅,吴学建,张德洪,等.皮肤弹性牵张法闭合小腿骨筋膜室高压减张切口[J].中国矫形外科杂志,2016,24(4):382-384.
[5]任义军,胡锐,严立,等.股前外侧组织瓣修复下肢多处皮肤软组织缺损[J].中华显微外科杂志,2015,38(5):447-450.
[6]桂万里,杨娥,张恒术.皮肤牵张器在瘢痕治疗中的临床应用效果观察[J].中华烧伤杂志,2017,33(3):139-144.
[7]李春光,徐亚非,唐秀霞,等.行改良动脉化静脉游离皮瓣术患者的护理[J].中华现代护理杂志,2013,19(20):2413-2414.
[8]李春光,徐亚非,唐兴秀,等.12例皮肤软组织缺损患者行小腿外侧皮支链皮瓣修复的护理[J].中华现代护理杂志,2015(36):4431-4433.
[9]汪桂琴,梁佳芝,田晓娜.VSD灸压弓一流技术治疗开放性骨折合并皮肤软组织缺损的护理研究[J].中国医学创新,2015,12(26):100-102.
[10]钱颖丹,王蓓.VSD治疗大面积撕脱伤及皮肤软组织缺损的护理体会[J].医药前沿,2017,7(8):298-299.
[11]雷少榕,黄晓元,谭婺远,等.皮肤扩张器埋植术后并发血肿原因分析与处理[J].中国美容医学,2015,4(7):16-18.
[12]付繁刚,曲军杰,孙德麟,等.足底内侧皮瓣经跟腱前转移修复中后足外侧皮肤软组织缺损[J].中华显微外科杂志,2016,39(5):462-464.
[13]鲁开化,艾玉峰,郭树忠等,新编皮肤软组织扩张术.第二军医大学出版社,上海,2007.
[14] Kreitzer MJ.Integrative nursing around the globe[J].glodAdv Health Med.2015.4(3):3-4.
[15]顾娟,曾丽,罗莉.医护一体化模式对住院患者治疗依从性的影响研究[J].实用临床医药杂志,2015,19(14):46-48.
[16]吕仁荣,傅洪滨.临床皮肤外科.济南:山东科学技术出版社,2014.
[17]彭小伟,喻建军等.游离皮瓣修复头颈缺损皮瓣坏死原因分析[J].中华耳鼻咽喉头颈外科杂志.2015.50(2):118-122.
[18]王珏,田涛,冯少清等.多层螺旋CT血管造影技术在穿支皮瓣修复下肢软组织缺损中的应用[J].中华显微外科杂志,2013,36(4):317-321.
[19]汤惠英,黄震佳,吴利.一次性注射器用于皮肤扩张器植入术后皮下积液引流效果观察与护理[J].医学美学美容-I临床研究,2015,6:222.
[20]张丽.6l例瘢痕旁和瘢痕下扩张器植入围手术期的护理差异分析[J].齐齐哈尔医学院学报,2015,36(28):4348-4349.
[21]朱金金.26例皮肤软组织扩张器埋植I期围手术期的护理[J].齐齐哈尔医学院学报,2015,6(36):933-934.
[22]高华,郑鹃.舒适护理在皮肤软组织扩张器植入术后患者中的应用[J].中国继续医学教育,2015,7(10):147-148.
[23]唐胜华,夏冬梅,陆思锭,等.皮肤软组织扩张术后并发症影响因素的探讨[J].中国美容整形外科杂志,2015,1(26):59-61.
[24] Konkel KF,Hussussian CJ.Technique Tip:Avoiding Wound Complications After a Large Opening Wedge Osteotomy of the Distal Tibia Using a Soft-Tissue Expander.Foot Ankle Int.2014,35(6):631-635.
[25] Formby P,Flint J,Gordon WT,et al.Use of a continuous external tissue expander in the conversion of a type IIIB fracture to a type IIIA fracture.Orthopedics.2013,36(2):e249-251.