封閉負(fù)壓引流術(shù)治療下肢骨折骨外露伴大面積軟組織損傷的護理效果觀察

李寒梅 張金枝

摘 要：目的 研究封閉負(fù)壓引流術(shù)治療下肢骨折骨外露伴大面積軟組織損傷患者的護理效果。方法 回顧分析2016年8月～2017年8月在我院采用封閉負(fù)壓引流術(shù)治療的116例下肢骨折骨外露伴大面積軟組織損傷患者臨床資料，隨機分為對照組和觀察組，各58例。對照組應(yīng)用常規(guī)護理，觀察組應(yīng)用針對性護理干預(yù)，觀察兩組患者臨床效果、傷口愈合時間、住院時間、換管次數(shù)及并發(fā)癥發(fā)生情況。結(jié)果 觀察組治療總有效率為96.55%，高于對照組的79.31%，差異有統(tǒng)計學(xué)意義（P<0.05）；觀察組在愈合時間、住院時間、換管次數(shù)均優(yōu)于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組并發(fā)癥發(fā)生率為1.72%，低于對照組的8.62%，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 針對性的護理干預(yù)在封閉負(fù)壓引流術(shù)治療下肢骨折骨外露伴大面積軟組織損傷中，對并預(yù)防發(fā)癥的發(fā)生，縮短住院時間，損傷的愈合有積極作用。

關(guān)鍵詞：封閉負(fù)壓引流術(shù)；下肢骨折；軟組織損傷

中圖分類號：R473.6 文獻標(biāo)識碼：A DOI：10.3969/j.issn.1006-1959.2018.23.052

文章編號：1006-1959（2018）23-0177-03

Abstract：Objective To study the nursing effect of closed negative pressure drainage in the treatment of lower limb fracture with bone exposure and large area of soft tissue injury. Methods The clinical data of 116 cases of lower limb fracture with bone exposure and large area of soft tissue injury treated by closed negative pressure drainage in our hospital from August 2016 to August 2017 were retrospectively analyzed. They were randomly divided into control group and observation group， with 58 cases in each group. Routine nursing was used in the control group， targeted nursing intervention was used in the observation group， and clinical effect， healing time， hospitalization time， frequency of catheter change and complications were observed in the two groups.Results The total effective rate of treatment in the observation group was 96.55%， higher than that in the control group 79.31%，the difference was statistically significant （P<0.05）. The observation group was superior to the control group in terms of healing time， hospitalization time and frequency of tube change，the difference was statistically significant （P<0.05）. The incidence of complications in the observation group was 1.72%， lower than that in the control group 8.62%，the difference was statistically significant （P<0.05）. Conclusion In the use of closed negative pressure drainage in the treatment of lower limb fracture bone exposure with large area of soft tissue injury， at the same time， to give targeted nursing intervention， can prevent the occurrence of complications， shorten the hospital stay， promote the healing of injury.

Key words：Closed negative pressure drainage；Fracture of lower limb；Soft tissue injury

下肢骨折骨外露伴大面積軟組織損傷患者，創(chuàng)面范圍通常較廣，損傷污染嚴(yán)重，且常合并肌肉、肌神經(jīng)以及深部組織損傷，如果臨床處理不當(dāng)，容易引起創(chuàng)面感染，影響創(chuàng)傷愈合，嚴(yán)重時甚至影響肢體功能[1]。封閉式負(fù)壓引流技術(shù)是臨床新興的引流技術(shù)，用醫(yī)用泡沫材料包裹多側(cè)孔引流管，使創(chuàng)面與外界完全隔絕，通過負(fù)壓源形成一個高效引流系統(tǒng)。該方法可有效保護和覆蓋創(chuàng)面，縮短創(chuàng)面愈合時間。但是需要注意的是，為了確保臨床治療效果，需要以針對性的護理干預(yù)為基礎(chǔ)[2]。本文結(jié)合2016年8月～2017年8月在我院治療的116例下肢骨折骨外露伴大面積軟組織損傷患者臨床資料，總結(jié)護理干預(yù)在該手術(shù)中的作用，現(xiàn)報告如下。

1資料與方法

1.1一般資料 選取2016年8月～2017年8月湖北省黃石市愛康醫(yī)院收治的116例下肢骨折骨外露伴大面積軟組織損傷患者，本研究經(jīng)醫(yī)院倫理會批準(zhǔn)。……