标题：流程化护理措施对VSD修复创伤性骨折合并软组织损伤的创面恢复及预后的影响

      作者：刘思婷，张志忠，陈琼    汉中市中心医院创伤骨科一病区，陕西 汉中 723000

      卷次： 2019年30卷13期

      【摘要】 目的 探究流程化护理措施对负压封闭引流(VSD)修复创伤性骨折合并软组织损伤的创面恢复及预后的影响。方法 选取汉中市中心医院创伤骨科一病区2017年10月至2018年12月收治的50例创伤性骨折合并软组织损伤的患者作为研究对象，按照随机数表法将患者分为观察组和对照组，每组25例。两组患者均采用VSD技术治疗，观察组患者采用流程化护理措施进行护理，对照组患者采用常规护理流程，比较两组患者治疗后的创面恢复情况、预后情况及患者满意度情况。结果 观察组患者二期植皮时间为(17.25±0.86) d，明显少于对照组的(24.64±5.74) d，换药次数为(3.20±1.44)次，明显少于对照组患者的(5.86±2.75)次，差异均有统计学意义(P<0.05)；而在二期植皮手术后的皮瓣成活方面，观察组的成活率为100.0%，明显高于对照组的84.0%，差异有统计学意义(P<0.05)；观察组患者的并发症发生率为8.0%，明显低于对照组的32.0%，差异有统计学意义(P<0.05)；观察组患者的术后满意程度为96.0%，明显高于对照组的76.0%，差异具有统计学意义(P<0.05)。结论 流程化护理措施可显著改善VSD修复创伤性骨折合并软组织损伤的创面恢复状况，降低并发症发生率，值得临床推广应用。
      【关键词】 流程化护理；临床护理路径；负压封闭引流系统；软组织缺损；骨科创伤；护理流程
      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1763—04

Effect of flow nursing on wound recovery and prognosis of traumatic fracture complicating soft tissue injurytreated by vacuum closed drainage.
LIU Si-ting, ZHANG Zhi-zhong, CHEN Qiong. First Department of Trauma andOrthopaedics, Hanzhong Central Hospital, Hanzhong 723000, Shaanxi, CHINA
【Abstract】 Objective To explore the effect of flow nursing on wound recovery and prognosis of traumatic frac-ture complicated with soft tissue injury treated by vacuum closed drainage (VSD). Methods Fifty patients with trau-matic fracture complicated with soft tissue injury admitted to Hanzhong Central Hospital from October 2017 to Decem-ber 2018 were selected as the research subjects. According to the random number table method, the patients were dividedinto observation group and control group, with 25 patients in each group. The two groups were both treated with vacuumsealing drainage (VSD) technology. The patients in the observation group were treated with flow nursing measures,while the patients in the control group were treated with routine nursing procedures. The wound recovery, prognosis, andpatients’satisfaction after treatment were compared between the two groups. Results The second-stage skin graftingtime in the observation group was (17.25±0.86) days, which was significantly shorter than (24.64±5.74) day in the con-trol group (P<0.05). The number of dressing changes after operation was 3.20±1.44, significantly less than 5.86±2.75 inthe control group (P<0.05). The survival rate in the observation group was 100.0%, significantly higher than 84.0% inthe control group (P<0.05). In the prognosis, the complication rate in the observation group was 8.0%, significantly low-er than 32.0% in the control group (P<0.05). The satisfaction degree of patients in the observation group was 96.0%, sig-nificantly higher than 76.0% of the control group (P<0.05). Conclusion Procedural nursing measures can effectivelypromote wound healing and reduce subsequent infections and complications in patients with traumatic fracture compli-cating soft tissue injury repaired by VSD, which is of great clinical value.
      【Key words】 Procedural nursing; Clinical nursing path; Vacuum closed drainage (VSD); Soft tissue defect; Or-thopaedic trauma; Nursing process·护理·doi:10.3969/j.issn.1003-6350.2019.13.037