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X 射线影像检查下断指再造术患者的保健康复护理效果及神经血管保护分析。

Effect of Health Care and Rehabilitation Nursing and Analysis of Neurovascular Preservation of Patients Undergoing Reconstruction of Severed Finger under X-ray Image Examination.

机构信息

Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang City, China.

Department of Spine, Third Hospital of Hebei Medical University, Shijiazhuang City, China.

出版信息

World Neurosurg. 2021 May;149:397-405. doi: 10.1016/j.wneu.2020.10.071. Epub 2020 Dec 1.

Abstract

OBJECTIVE

The study aimed to provide a guideline for continuous rehabilitation nursing for patients with severe finger replantation, and establish a satellite contact point for patients with severe finger replantation after discharge, so as to ensure scientific and effective rehabilitation training after discharge and explore the role of continuous rehabilitation nursing measurement in severe finger rehabilitation and neurovascular preservation.

METHODS

A total of 380 patients accepting neurovascular preservation finger replantation in the hand surgery department were divided into an observation group and a control group according to the number of hospitalizations. All patients underwent reconstructive surgery of severed finger. X-ray filming was used to monitor the postoperative nursing effect of neurovascular preservation of severed finger. The discharged patient information questionnaire was filled 3 days before the discharge. Then, a patient information database was established, and rehabilitation training was performed. Finally, sexual rehabilitation nursing follow-up intervention, telephone follow-up, and cross-referring intervention were carried out. Postoperative x-ray images were taken regularly to observe the recovery of reconstructed finger.

RESULTS

There was no difference in daily life ability scores and hand function scores between the 2 groups at discharge (P > 0.05). The daily life ability scores and hand function scores of the observation group were better than those of the control group at 1 and 6 months after discharge (P < 0.05), the difference is statistically significant. As the discharge time prolonged, the daily life ability score and hand function score of the 2 groups of patients gradually increased. X-ray images showed that the replanted finger body was well developed, phalanx was in good antithesis, and there was no epiphysis.

CONCLUSIONS

Continuous rehabilitation nursing measures should be taken after the replantation of the severed finger after neurovascular preservation, which provides standardized rehabilitation training standards for patients with replantation of severed finger after discharge, improves patient training compliance, promotes hand function recovery as soon as possible, and enables patients to return to society as soon as possible, which is worthy of clinical promotion and application.

摘要

目的

为严重断指再植患者提供连续康复护理指导,为出院后的严重断指再植患者建立卫星联络点,确保患者出院后康复训练的科学性和有效性,探索连续康复护理措施在严重断指康复及神经血管保护中的作用。

方法

将手外科收治的 380 例接受神经血管保护断指再植的患者,根据住院号尾数分为观察组和对照组。所有患者均行断指再植修复术,术后采用 X 线片监测神经血管保护断指再植的护理效果,在出院前 3 天填写出院患者信息问卷,建立患者信息数据库,进行康复训练,最后进行康复护理随访干预、电话随访、交叉干预。定期拍摄术后 X 线片,观察重建手指的恢复情况。

结果

两组患者出院时日常生活能力评分和手部功能评分比较差异无统计学意义(P>0.05),观察组患者出院后 1 个月和 6 个月的日常生活能力评分和手部功能评分均优于对照组,差异有统计学意义(P<0.05),随着出院时间的延长,两组患者的日常生活能力评分和手部功能评分逐渐升高。X 线片显示,再植指体发育良好,指骨对位良好,无骨骺。

结论

对神经血管保护下断指再植患者采取连续康复护理措施,为出院后断指再植患者提供规范化的康复训练标准,提高患者的训练依从性,促进手功能尽早恢复,使患者尽快回归社会,值得临床推广应用。

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