目的:探讨针对手臂部烧伤施以整形植皮治疗的患者重视综合康复护理方案的开展,对并发症的防控及对手臂功能恢复的促进作用。方法: 选取手臂烧伤施以整形植皮治疗的患者100例,均为我院2019年1月至2020年1月收治,应用数字表抽取法随机分组,就采用常规康复护理方案(对照组,n = 50)与采用综合康复护理方案(观察组,n = 50)并发症率、疼痛评分、手臂功能评分展开对比。结果:观察组急性肾衰竭、应激性溃疡、创面渗血、创面脓毒症等并发症率经观测明显低于对照组,差异具有统计学意义(P < 0.05)。两组护理前,经对疼痛评分进行评测,差异无统计学意义(P > 0.05),护理后,评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。两组开展护理前,手臂功能各维度即手功能、手活动能力评分经评测无差异(P > 0.05),在护理后,各评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。结论:针对临床收治的手臂部烧伤施以整形植皮治疗的患者,重视开展综合康复护理,可对急性肾衰竭、应激性溃疡等并发症进行防范,降低疼痛程度,改善手臂功能,开展价值显著。 Objective: To investigate the importance of comprehensive rehabilitation nursing plan for patients undergoing orthopedic skin grafting treatment for arm burns, prevention and control of complications, and promotion of arm function recovery. Methods: A total of 100 patients who received plastic skin grafting treatment for arm burns were selected. They were all admitted to our hospital from January 2019 to January 2020. They were randomly divided into groups using the digital table extraction method, and the conventional rehabilitation care plan was adopted (control group, n = 50). The complication rate, pain score, and arm function score were compared with the comprehensive rehabilitation nursing program (observation group, n = 50). Results: The rate of complications such as acute renal failure, stress ulcer, wound oozing, and wound sepsis in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). The pain scores of the two groups were evaluated before nursing, and the difference was not statistically significant (P > 0.05). After nursing, the evaluation scores were reduced, and compared with the control group, the observation group had more obvious changes, and the difference was statistically significant (P < 0.05). Before the two groups started nursing, there was no difference in the scores of arm function, namely hand function and hand movement ability after evaluation (P > 0.05). After nursing, the evaluation scores were reduced, and compared with the control group, the observation group had more changes, the difference is statistically significant (P < 0.05). Conclusion: For the clinically admitted patients with arm burns undergoing plastic skin grafting treatment, comprehensive rehabilitation care should be emphasized, which can prevent acute renal failure, stress ulcers and other complications, reduce pain, improve arm function, and have significant development value.
目的:探讨针对手臂部烧伤施以整形植皮治疗的患者重视综合康复护理方案的开展,对并发症的防控及对手臂功能恢复的促进作用。方法:选取手臂烧伤施以整形植皮治疗的患者100例,均为我院2019年1月至2020年1月收治,应用数字表抽取法随机分组,就采用常规康复护理方案(对照组,n = 50)与采用综合康复护理方案(观察组,n = 50)并发症率、疼痛评分、手臂功能评分展开对比。结果:观察组急性肾衰竭、应激性溃疡、创面渗血、创面脓毒症等并发症率经观测明显低于对照组,差异具有统计学意义(P < 0.05)。两组护理前,经对疼痛评分进行评测,差异无统计学意义(P > 0.05),护理后,评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。两组开展护理前,手臂功能各维度即手功能、手活动能力评分经评测无差异(P > 0.05),在护理后,各评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。结论:针对临床收治的手臂部烧伤施以整形植皮治疗的患者,重视开展综合康复护理,可对急性肾衰竭、应激性溃疡等并发症进行防范,降低疼痛程度,改善手臂功能,开展价值显著。
手臂部烧伤,整形植皮,综合康复护理,并发症,疼痛评分,手臂功能
Feiyan Chen
Guizhou Bijie First People’s Hospital, Bijie Guizhou
Received: May 13th, 2021; accepted: Jun. 13th, 2021; published: Jun. 21st, 2021
Objective: To investigate the importance of comprehensive rehabilitation nursing plan for patients undergoing orthopedic skin grafting treatment for arm burns, prevention and control of complications, and promotion of arm function recovery. Methods: A total of 100 patients who received plastic skin grafting treatment for arm burns were selected. They were all admitted to our hospital from January 2019 to January 2020. They were randomly divided into groups using the digital table extraction method, and the conventional rehabilitation care plan was adopted (control group, n = 50). The complication rate, pain score, and arm function score were compared with the comprehensive rehabilitation nursing program (observation group, n = 50). Results: The rate of complications such as acute renal failure, stress ulcer, wound oozing, and wound sepsis in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). The pain scores of the two groups were evaluated before nursing, and the difference was not statistically significant (P > 0.05). After nursing, the evaluation scores were reduced, and compared with the control group, the observation group had more obvious changes, and the difference was statistically significant (P < 0.05). Before the two groups started nursing, there was no difference in the scores of arm function, namely hand function and hand movement ability after evaluation (P > 0.05). After nursing, the evaluation scores were reduced, and compared with the control group, the observation group had more changes, the difference is statistically significant (P < 0.05). Conclusion: For the clinically admitted patients with arm burns undergoing plastic skin grafting treatment, comprehensive rehabilitation care should be emphasized, which can prevent acute renal failure, stress ulcers and other complications, reduce pain, improve arm function, and have significant development value.
Keywords:Arm Burn, Plastic Skin Graft, Comprehensive Rehabilitation Care, Complications, Pain Score, Arm Function
Copyright © 2021 by author(s) and Hans Publishers Inc.
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烧伤为多发性意外伤害类型,为由电流、化学物质、放射线、热力等引发的组织损伤。手臂为人体参与学习和劳动,以及与外物接触的常用部位,有较高的烧伤风险 [
选取手臂烧伤施以整形植皮治疗的患者100例,均为我院2019年1月至2020年1月收治,采用数字表法随机分组。观察组50例中,男29例,女21例,年龄介于41~82岁之间,平均(54.95 ± 3.72)岁;受伤面积介于5%~16%之间,平均(8.17 ± 0.69)%。对照组50例中,男27例,女23例,年龄介于38~81岁之间,平均(54.72 ± 3.84)岁;受伤面积介于4%~15%之间,平均(8.23 ± 0.63)%。组间基线资料具均衡性(P > 0.05)。
纳入标准:1) 经临床检查对手臂部烧伤确诊;2) 无意识及精神障碍;3) 对本次实验知情同意,并报伦理学组织委员会批准,临床资料完整。排除标准:1) 有内分泌系统、神经系统疾病合并者;2) 有心、肺疾病合并者。
对照组应用常规康复手段,观察组应用综合康复护理手段。具体内容包括:1) 压迫疗法:在拆线后,即应用压迫疗法实施干预,指导取弹力手套配戴,压力于25 mmHg控制。在配戴过程中,将手指指端露出,以为对手臂血运观察创造条件,在初始持续应用24 h,用时1个月,后调整为夜晚使用。2) 按摩干预:对患肢进行局部按摩,使力度在关节间隙处、植皮区域、皮下组织、植皮边缘处作用。3) 肌力训练:针对手臂前壁、内在肌力进行训练,指导做手指的系列抗阻运动,每次20 min,每日3次;4) 微波疗法:对伤口表面应用SW-61A微波进行照射,功率设置在15~30 W,频率设置在2405 MHz,并与包扎紧贴移动,每次15~20 min,每日1~2次,1个疗程为7~10次。5) 康复指导:待瘢痕稳定,对主动锻炼方法进行指导,包括手腕旋转或屈曲、对指、握拳等,每次15~30 min,每日3~4次,可由支具协助。
1) 并发症比较:对比两组施以整形植皮治疗急性肾衰竭、创面脓毒症、创面渗血、应激性溃疡等并发症发生率。2) 疼痛程度对比:应用视觉模拟评分法(VAS) [
测验数据均在SPSS22.0中录入,计数资料即并发症率在表述时应用(%),经c2检验对结果获取,计量资料即疼痛评分、手臂功能评分在表述时应用( x ¯ ± s ),经t检验对结果获取,P < 0.05差异具有统计学意义。
观察组急性肾衰竭、应激性溃疡、创面渗血、创面脓毒症等并发症率经观测明显低于对照组,差异具有统计学意义(P < 0.05)。见表1。
组别 | 急性肾衰竭 | 应激性溃疡 | 创面渗血 | 创面脓毒症 | 其它 | 并发症率 |
---|---|---|---|---|---|---|
观察组(n = 50) | 0 (0.00) | 1 (2.00) | 1 (2.00) | 1 (2.00) | 1 (2.00) | 3 (6.00) |
对照组(n = 50) | 1 (2.00) | 4 (8.00) | 2 (4.00) | 2 (4.00) | 3 (6.00) | 12 (24.00) |
c2 | - | - | - | - | - | 6.353 |
P | - | - | - | - | - | 0.012 |
表1. 两组并发症率对比情况[n (%)]
两组护理前,经对疼痛评分进行评测,差异无统计学意义(P > 0.05),护理后,评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。见表2。
组别 | 护理前 | 护理后 |
---|---|---|
观察组(n = 50) | 6.31 ± 1.22 | 2.17 ± 0.45 |
对照组(n = 50) | 6.34 ± 1.19 | 4.82 ± 0.72 |
t | 0.124 | 22.070 |
P | 0.901 | 0.000 |
表2. 两组疼痛评分对比情况[( x ¯ ± s )分]
两组开展护理前,手臂功能各维度即手功能、手活动能力评分经评测无差异(P > 0.05),在护理后,各评测分值均有降低,且与对照组比较,观察组变化更为明显,差异具有统计学意义(P < 0.05)。见表3。
组别 | 手功能 | 手活动能力 | ||
---|---|---|---|---|
护理前 | 护理后 | 护理前 | 护理后 | |
观察组(n = 50) | 18.29 ± 3.05 | 5.28 ± 0.71 | 20.36 ± 2.98 | 8.17 ± 1.04 |
对照组(n = 50) | 18.87 ± 2.96 | 8.29 ± 1.63 | 20.19 ± 2.82 | 13.29 ± 2.18 |
t | 0.965 | 11.971 | 0.293 | 14.989 |
P | 0.337 | 0.000 | 0.770 | 0.000 |
表3. 两组手臂功能评分对比情况[( x ¯ ± s )分]
手臂有相对复杂的解剖结构,在烧伤后,特别是重度烧伤,若未有效、合理予以治疗,可引发程度不等的并发症,使手臂畸形风险明显增加,促使手臂功能受到严重影响,进而使生活质量下降,故在采取有效方法治疗的同时,对康复护理也有较高的要求。
综合康复护理为现代护理重要形式,可经对多元、系统的措施运用,指导患者开展功能锻炼,以对自理能力的恢复发挥促进作用,减轻身心痛苦程度 [
综上,针对临床收治的手臂部烧伤施以整形植皮治疗的患者,重视开展综合康复护理,可对急性肾衰竭、应激性溃疡等并发症进行防范,降低疼痛程度,改善手臂功能,开展价值显著。
陈飞艳. 综合康复护理对减少手臂部烧伤整形植皮患者并发症及促进患者手臂功能恢复影响研究Study on the Effect of Comprehensive Rehabilitation Nursing on Reducing the Complications of Patients with Arm Burns and Plastic Skin Grafting and Promoting the Recovery of Patients’ Arm Function[J]. 护理学, 2021, 10(03): 195-199. https://doi.org/10.12677/NS.2021.103032