围术期多元化保温措施在四肢严重挤压伤创面游离皮瓣修复术后护理中的<br />应用<br />-《中国美容医学》

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Title:: Application of Perioperative Diversified Thermal Insulation Measures in Postoperative
Nursing of Free Flap Repair of Severe Crush Wound of Limbs

文章编号:: 1008-6455（2021）10-0175-03

作者:: 马娜; 马璐; 苏敏; 杨敏利

Author(s):: MA Na; MA Lu; SU Min; YANG Min-li

关键词:: [关键词]围术期护理; 多元化保温措施; 游离皮瓣移植术; 血管危象; 挤压伤

Keywords:: Key words: perioperative nursing; diversified thermal insulation measure; free flap transplantation; vascular crisis; crush injury

分类号:: R473.6

文献标志码:: B

摘要:: [摘要]目的：探讨围术期多元化保温措施在四肢严重挤压伤创面游离皮瓣移植术后护理中的应用。方法：选取2017年1
月-2020年1月于笔者医院治疗四肢严重挤压伤创面的102例患者作为研究对象，均采取游离皮瓣移植术，根据围术期保温措
施不同分为观察组（52例）和对照组（50例），其中对照组采取常规保温干预，观察组采取多元化保温干预，比较两组患
者在干预处理后局部血运情况、血管危象发生情况以及局部皮瓣成活情况。结果：观察组毛细血管充盈时间评分、局部皮
瓣弹性评分均显著高于对照组，差异有统计学意义（P ＜0.05）。观察组血管危象一期与二期发生率均显著低于对照组，
差异有统计学意义（P ＜0.05）；三、四期比较差异无统计学意义（P ＞0.05）。观察组血管危象发生率为11.54%，明显
低于对照组的30.00%；观察组皮瓣存活率为94.23%，明显高于对照组的78.00%，差异均统计学意义（P ＜0.05）。结论：
在游离皮瓣移植术围术期采取多元化保温干预，不仅有利于改善皮瓣局部血液循环，同时还有助于降低血管危象发生率，
提高皮瓣成活率，在临床上值得推广应用。

Abstract:: Abstract: Objective To investigate the application of perioperative diversified thermal insulation measures in postoperative
nursing of free flap repair of severe crush wound of limbs. Methods From January 2017 to January 2020, 102 patients with
severe crush wounds on extremities treated by free skin flap transplantation were selected as study subjects. According to the
perioperative diversified thermal insulation measure, the patients were divided into the observation group (52 cases, diversified
thermal insulation measure) and the control group (50 cases, conventional thermal insulation). The local blood supply, the
incidence of vascular crisis and the survival of local skin flaps after intervention were compared between the two groups.
Results The scores for capillary filling time and local flap elasticity of the observation group were higher than those of the
control group, the difference was statistically significant (P ＜0.05). The incidence of phase Ⅰ and phaseⅡ vascular crisis in
the observation group were significantly lower than those in the control group (P ＜0.05). There was no significant difference in
the incidence of phase Ⅲ and phase Ⅳ vascular crisis (P ＞0.05). The incidence of vascular crisis in the observation group was
11.54%, significantly lower than that in the control group (30.00%, P ＜0.05). The flap survival rate in the observation group
was 94.23% significantly higher than that in the control group (78.00%, P ＜0.0). Conclusion Adopting diversified thermal
insulation intervention during the perioperative period of free flap transplantation not only is beneficial to improve the local
blood circulation of the flap, but also helps to reduce the incidence of vascular crisis and increase the survival rate of flaps.

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

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