康复护理干预促进深Ⅱ度下肢烧伤患者植皮术后创面恢复与生活质量提升

刘希娟; 陈洁; 马英豪; 朱虹; 郎蕊; 王晓东

doi:10.16016/j.2097-0927.202303077

您当前的位置：

首页 >

文章列表页 >

康复护理干预促进深Ⅱ度下肢烧伤患者植皮术后创面恢复与生活质量提升

临床医学 | 更新时间：2026-01-09

- 康复护理干预促进深Ⅱ度下肢烧伤患者植皮术后创面恢复与生活质量提升
- Effects of postoperative rehabilitation nursing on recovery and quality of life in deep degree Ⅱ lower limb burns patients after dermatoplasty
- 陆军军医大学学报 2023年45卷第8期页码：854-860
- 作者机构：
  
  1.100088 北京，中国人民解放军火箭军特色医学中心：质量管理科
  2.100088 北京，中国人民解放军火箭军特色医学中心：烧伤整形科
- 作者简介：
  
  [王晓东，E-mail：348547399@qq.comWANG Xiaodong, E-mail: 348547399@qq.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202303077
  中图分类号： R493; R473.3; R644
- 收稿：2023-03-02，
  
  修回：2023-04-09，
  
  纸质出版：2023-04-30
- 稿件说明：
移动端阅览
刘希娟, 陈洁, 马英豪, 等. 康复护理干预促进深Ⅱ度下肢烧伤患者植皮术后创面恢复与生活质量提升[J]. 陆军军医大学学报, 2023,45(8):854-860.

Xijuan LIU, Jie CHEN, Yinghao MA, et al. Effects of postoperative rehabilitation nursing on recovery and quality of life in deep degree Ⅱ lower limb burns patients after dermatoplasty[J]. Journal of Army Medical University, 2023, 45(8): 854-860.
刘希娟, 陈洁, 马英豪, 等. 康复护理干预促进深Ⅱ度下肢烧伤患者植皮术后创面恢复与生活质量提升[J]. 陆军军医大学学报, 2023,45(8):854-860. DOI： 10.16016/j.2097-0927.202303077.

Xijuan LIU, Jie CHEN, Yinghao MA, et al. Effects of postoperative rehabilitation nursing on recovery and quality of life in deep degree Ⅱ lower limb burns patients after dermatoplasty[J]. Journal of Army Medical University, 2023, 45(8): 854-860. DOI： 10.16016/j.2097-0927.202303077.

摘要

目的

探究深Ⅱ度下肢烧伤患者接受植皮修复术后康复护理对患者创面恢复及生活质量的影响。

方法

选择火箭军特色医学中心烧伤整形科2020年1月至2023年1月首诊为深Ⅱ度下肢烧伤并均给予植皮修复手术治疗的患者68例，采用数字表法随机分为干预组和对照组(

=34)。对照组患者给予常规术后护理，干预组接受常规护理基础上术后康复护理。护理4周后，评估护理后各组患者创面愈合时间和术后并发症发生率，采用疼痛视觉模拟评分(visual analogue scale，VAS)评估患者疼痛程度，护理前后采用焦虑自评量表(self-rating anxiety scale

SAS)和抑郁自评量表(self-rating depression scale

SDS)评估患者负性情绪，采用简式FMA(Fugl-Meyer assessment)评分法评估患者术后下肢运动功能恢复情况，采用QOL(quality of life score)问卷调查表评估术后生活质量改善。

结果

接受康复护理4周后，干预组的创面愈合时间(9.25±5.32)d较对照组均显著缩短(

愈合

=2.059，

0.05)，且术后不良并发症发生率(5.88%)显著降低(

=4.221，

0.05)。患者在接受护理后，负性情绪评估SAS评分、SDS评分均显著低于护理前(

0.05)，以接受干预组患者评分降低显著(

0.001)。两组患者4周后的VAS评分、FMA评分、QOL问卷调查评分均较护理前明显升高(

对照

分别为-6.769、-7.099、-3.026，

干预

分别为-7.077、-7.111、-6.108，

0.05)，且干预组接受康复护理后的疼痛改善、下肢运动功能和生活质量提升均较对照组评分明显升高(

护理后

分别为-3.116、-5.958、-4.079，

0.05)。

结论

术后康复护理能促进深Ⅱ度下肢烧伤患者创面愈合，明显降低术后并发症发生率，调节患者负性情绪，有利于下肢运动功能尽早恢复和术后生活质量的提升。

Abstract

Objective

To determine the impact of postoperative rehabilitation nursing on the recovery and quality of life in deep degree Ⅱ lower limb burn patients.

Methods

A randomized controlled clinical trial was conducted on 68 patients with deep burn admitted to our center between January 2020 and January 2023. The patients were allocated into control group (

=34

conventional postoperative nursing) and intervention group (

=34

conventional postoperative nursing combined with postoperative rehabilitation nursing). In 4 weeks after intervention

wound healing (time of wound healing and wound blood flow recovery) and incidence of postoperative complications were observed. Visual analog scale (VAS) was used to score the pain

and Anxiety Self-assessment Scale (SAS) and Depression Self-assessment Scale (SDS) were employed to assess the patients' negative emotions. Simple Fugl-Meyer assessment (FMA) was adopted to evaluate the lower limb motor function

and Quality of Life scale (QOL) was conducted for their quality of life.

Results

After 4 weeks of training

the intervention group obtained a significantly shorter time of wound healing (28.67±4.32 d

healing

=11.555

0.001) and lower incidence of postoperative complications (5.88%

Chi-square

=4.221

0.05

) when compared with the control group. The interventions obviously reduced the SAS score and SDS score of negative emotions than the baseline scores before training (

0.05)

with the decreases more statistically significant in the intervention group (

0.001). After 4 weeks of training

VAS score

FMA score

and QOL scores were all significantly improved compared with those before (

value= -6.769

-7.099

-3.026 in the control group

value=-7.077

-7.111

-6.108 in the intervention group

0.05). The improvement of pain

lower limb motor function and quality of life were greatly higher in the intervention group than the control group (

value=-3.116

-5.958

-4.079 after training

0.05).

Conclusion

Postoperative rehabilitation nursing can significantly promote the recovery of wound healing

reduce the postoperative complications

regulate patients' negative emotions

benefit lower limb motor function recovery earlier

and effectively improve the postoperative quality in the patients with deep Ⅱ lower limb burns.

关键词

Keywords

references

DAI N T, CHANG H I, WANG Y W, et al . Restoration of skin pigmentation after deep partial or full-thickness burn injury[J ] . Adv Drug Deliv Rev, 2018, 123: 155-164. DOI: 10.1016/j.addr.2017.10.010.

JIAO H B, TIAN T, CHEN C J, et al . Effect of vacuum sealing drainage plus skin grafting on deep burns and analysis of risk factors for postoperative infection[J ] . Am J Transl Res, 2022, 14(10): 7477-7486.

DAIGELER A, KAPALSCHINSKI N, LEHNHARDT M. Therapie von brandverletzungen[J]. Chirurg, 2015, 86(4): 389-401. DOI: 10.1007/s00104-014-2919-3.

Chinese Burn Association, Chinese Burn Surgeons Association. Burn Rehabilitation Guidelines (2013 Edition)[J]. Chin J Burns, December 2013, 29(6): 497-504.

孙林利, 陈丽娟, 程雨虹, 等. 2018年《ISBI烧伤处理实践指南(第2部分)》解读[J]. 护理研究, 2020, 34(8): 1305-1310. DOI: 10.12102/j.issn.1009-6493.2020.08.001.

SUN L L, CHEN L J, CHENG Y H, et al . Interpretation for "ISBI Practice Guidelines for Burn Care, Part 2"[J ] . Chin Nurs Res, 2020, 34(8): 1305-1310. DOI: 10.12102/j.issn.1009-6493.2020.08.001.

侯府青, 郭春萍, 宗雅慧. 植皮修复面部烧伤的临床护理路径[J]. 中国医疗美容, 2019, 9(5): 90-93. DOI: 10.19593/j.issn.2095-0721.2019.05.024.

HOU F Q, GUO C P, ZONG Y H. Clinical nursing pathway of skin grafting repair for facial burn[J]. China Med Cosmetol, 2019, 9(5): 90-93. DOI: 10.19593/j.issn.2095-0721.2019.05.024.

赵海洋, 刘佳琦, 韩军涛, 等. 渐进式核心肌群训练联合下肢智能康复训练对烧伤患者下肢功能障碍影响的前瞻性随机对照研究[J]. 中华烧伤与创面修复杂志, 2022, 38(12): 1117-1125. DOI: 10.3760/cma.j.cn501225-20220616-00236.

ZHAO H Y, LIU J Q, HAN J T, et al . A prospective randomized controlled study on the effects of progressive core muscle group training combined with lower limb intelligent rehabilitation training for burn patients with lower limb dysfunction[J ] . Chin J Burns Wounds, 2022(12): 1117-1125. DOI: 10.3760/cma.j.cn501225-20220616-00236.

杜彩凤, 李华. 认知行为疗法对深Ⅱ度烧伤患者心理状态、疼痛及并发症的影响[J]. 中国健康心理学杂志, 2021, 29(7): 978-983. DOI: 10.13342/j.cnki.cjhp.2021.07.005.

DU C F, LI H. Effects of cognitive behavioral therapy on mental state, pain and complications in patients with deepⅡ degree burn[J]. China J Health Psychol, 2021, 29(7): 978-983. DOI: 10.13342/j.cnki.cjhp.2021.07.005.

王洪涛, 韩军涛, 胡大海. 炎症反应在增生性瘢痕和瘢痕疙瘩形成中的作用及其机制研究进展[J]. 中华烧伤杂志, 2021, 37(5): 490-494. DOI: 10.3760/cma.j.cn501120-20200310-00143.

WANG H T, HAN J T, HU D H. Research advances on the role and mechanism of inflammatory response in the formation of hypertrophic scars and keloids[J]. Chin J Burns, 2021, 37(5): 490-494. DOI: 10.3760/cma.j.cn501120-20200310-00143.

龙航, 徐佳丽, 张小林, 等. 芭克硅胶软膏联合压力疗法防治面部深Ⅱ度烧伤后瘢痕疗效观察[J]. 中国烧伤创疡杂志, 2021, 33(5): 365-368. DOI: 10.3969/j.issn.1001-0726.2021.05.016.

LONG H, XU J L, ZHANG X L, et al . Observation on the clinical efficacy of silicone gel (scar gel) combined with the pressure therapy in the prevention and treatment of scar following facial deep Ⅱ degree burns[J ] . Chin J Burns Wounds Surf Ulcers, 2021, 33(5): 365-368. DOI: 10.3969/j.issn.1001-0726.2021.05.016.

王鑫, 岳立明, 马志国, 等. 创面切削痂植皮手术在深度烧伤创面患者中的应用研究[J]. 世界复合医学, 2021, 7(2): 109-111. DOI: 10.11966/j.issn.2095-994X.2021.07.02.36.

WANG X, YUE L M, MA Z G, et al . Study on the application of wound cutting and skin grafting in patients with deep burn wounds[J ] . World J Complex Med, 2021, 7(2): 109-111. DOI: 10.11966/j.issn.2095-994X.2021.07.02.36.

牛雪涛, 赵举辉, 李子标. Meek植皮术联合纳米银敷料治疗在大面积烧伤创面修复中的应用[J]. 海南医学, 2023, 34(5): 646-649. DOI: 10.3969/j.issn.1003-6350.2023.05.010.

NIU X T, ZHAO J H, LI Z B. Application of Meek skin grafting combined with nanometer silver dressing in the repair of extensive burn wounds[J]. J Hainan Med, 2023, 34(5): 646-649. DOI: 10.3969/j.issn.1003-6350.2023.05.010.

季建林. 医学心理学(第四版)[M]. 上海: 复旦大学出版社, 2008: 230-231.

JI J L. Psychological medicine (4th Edition)[M]. Shanghai: Fudan University Press, 2008: 230-231.

杨文元. 温水下运动训练对特重度烧伤患者下肢运动功能的影响[J]. 中国疗养医学, 2020, 29(01): 24-25. DOI: 10.13517/j.cnki.ccm.2020.01.008.

YANG W Y. Effect of warm water exercise training on motor function of lower limbs in patients with severe burns[J]. Chin J Conval Med, 2020, 29(1): 24-25. DOI: 10.13517/j.cnki.ccm.2020.01.008.

ZHOU L, LIU C M, LUO Y M, et al . Diverse treatments for deep burn wounds: a case report[J ] . Adv Skin Wound Care, 2021, 34(4): 1-6. DOI: 10.1097/01.ASW.0000734392.64937.56.

PENG H, YUE L Q, GAO H M, et al . Risk assessment of deep venous thrombosis and its influencing factors in burn patients[J ] . J Burn Care Res, 2020, 41(1): 113-120. DOI: 10.1093/jbcr/irz121.

王德昌, 赵冉. 重视磨痂术在早期深Ⅱ度烧伤创面的应用[J]. 中华烧伤杂志, 2020, 36(6): 506-509. DOI: 10.3760/cma.j.cn501120-20190115-00007.

WANG D C, ZHAO R. Focus on application of dermabrasion in the treatment of deep partial-thickness burn wound at early stage[J]. Chin J Burns, 2020, 36(6): 506-509. DOI: 10.3760/cma.j.cn501120-20190115-00007.

彭欢, 梁鹏飞, 王昂, 等. 不同康复方法对手部深度烧伤保留变性真皮并移植大张自体皮患者手功能及焦虑心理的影响[J]. 中华烧伤杂志, 2017, 33(5): 272-276. DOI: 10.3760/cma.j.issn.1009-2587.2017.05.004.

PENG H, LIANG P F, WANG A, et al . Influences of different rehabilitative methods on function of hands and psychological anxiety of patients with deeply burned hands retaining denatured dermis and grafting large autologous skin[J ] . Chin J Burns, 2017, 33(5): 272-276. DOI: 10.3760/cma.j.issn.1009-2587.2017.05.004.

岳丽青, 王晓燕, 彭欢, 等. 康复路径对深度烧伤手术后康复效果的影响[J]. 中国现代医学杂志, 2016, 26(7): 126-132.

YUE L Q, WANG X Y, PENG H, et al . Effect of rehabilitation pathway on postoperative recovery of deep burn hands[J ] . China J Mod Med, 2016, 26(7): 126-132.

张爱梅. 康复护理干预对深度烧伤患者术后恢复和生活质量的影响[J]. 齐鲁护理杂志, 2014, 20(18): 45-46. DOI: 10.3969/j.issn.1006-7256.2014.18.024.

ZHANG A M. Effect of rehabilitation nursing intervention on postoperative recovery and quality of life of deep burn patients[J]. J Qilu Nurs, 2014, 20(18): 45-46. DOI: 10.3969/j.issn.1006-7256.2014.18.024.

雍雪, 王燕萍, 吴美. 康复护理干预对深度烧伤患者术后恢复和生活质量的影响[J]. 双足与保健, 2017, 26(18): 43, 45. DOI: 10.19589/j.cnki.issn1004-6569.2017.18.043.

YONG X, WANG Y P, WU M. Effect of rehabilitation nursing intervention on postoperative recovery and quality of life of deep burn patients[J]. Biped Health, 2017, 26(18): 43, 45. DOI: 10.19589/j.cnki.issn1004-6569.2017.18.043.

向红霞, 洪翠琼, 郑娟丽. 心理干预对改善大面积深度烧伤患者负性情绪的影响[J]. 齐鲁护理杂志, 2009, 15(20): 34-35.

XIANG H X, HONG C Q, ZHENG J L. Effect of psychological intervention on improving negative emotions in patients with extensive deep burns[J]. J Qilu Nurs, 2009, 15(20): 34-35.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

脊髓发育异常对先天性肛门直肠畸形患儿排便功能及生活质量的影响

心房颤动患者的生活质量及其影响因素分析

外周血炎症因子与房颤患者生活质量的关联研究

退变性脊柱畸形患者腰背肌力量耐力水平及与生活质量的相关性分析

不同家庭照护模式对慢性病患儿生活质量的影响