康复路径对深度烧伤手术后康复效果的影响

发布时间：2018-05-30 19:09

本文选题：手 + 烧伤　；参考：《中国现代医学杂志》2016年07期

【摘要】：目的通过制定、执行深度烧伤手康复路径,评估其对烧伤手切削痂植皮术后患者康复效果的影响。方法选择2012年1月-2013年12月深度烧伤手采用早期切削痂+自体中厚皮移植的成年患者43例,随机分为对照组和实验组。对照组患者采用手烧伤常规护理、教育督促和接受患者咨询的方式实施康复;实验组患者从瘢痕预防、运动与功能康复、健康教育和心理支持4个主要范畴制定康复路径表,专人按康复路径实施各阶段的康复和指导,并定时电话随访。两组患者使用密歇根手功能量表(MHQ)、温哥华瘢痕量表(VSS)、焦虑自评量表(SAS),分别评估伤后1、3和6个月的患手整体功能、瘢痕情况和心理状态,并进行比较。结果实验组患者1、3和6个月的MHQ、VSS、SAS总得分优于对照组。实验组伤后1、3和6个月的MHQ总得分比对照组高(P0.01);VSS总得分比对照组低(P0.01);SAS得分比对照组低(P0.01)。结论手深度烧伤康复路径的实施能有效地提高烧伤手的整体功能,降低瘢痕严重程度,改善患者的心理状态。
[Abstract]:Objective to evaluate the effect of deep burn hand healing pathway on the recovery of burn patients after hand escharectomy and skin grafting. Methods Forty-three adult patients with deep burn from January 2012 to December 2013 were randomly divided into two groups: control group and experimental group. The patients in the control group were rehabilitated by routine nursing, education, supervision and consultation, and the patients in the experimental group were divided into four main categories: scar prevention, exercise and functional rehabilitation, health education and psychological support. Personnel according to the rehabilitation path to implement the rehabilitation and guidance, and regular telephone follow-up. Michigan hand function scale (MHQN), Vancouver scar scale (VSSN), and self rating anxiety scale (SAS) were used to evaluate the overall function, scar status and psychological status of the affected hands 1 and 6 months after injury, respectively. Results the total scores of MHQ and VSS SAS in the experimental group were better than those in the control group at 3 and 6 months. The total score of MHQ in the experimental group was higher than that in the control group at the 3rd and 6th months after injury. The total score of MHQ was lower than that of the control group (P 0.01) and that of the control group was lower than that of the control group (P 0.01). Conclusion the implementation of rehabilitation pathway for deep hand burn can effectively improve the whole function of burn hand, reduce the severity of scar, and improve the psychological state of the patients.
【作者单位】：中南大学湘雅医院护理部;中南大学湘雅医院烧伤重建外科;中南大学湘雅医院感染病科;
【分类号】：R473.6

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