摘要
目的探讨专科护士主导的医护一体化创面诊疗模式在下肢慢性感染性创面伴骨外露修复中的应用效果。方法回顾性分析2019年1月至2021年12月期间武汉大学中南医院创伤与显微骨科收治的64例下肢慢性感染性创面伴骨外露患者资料,创面部位均在小腿下1/3区域。根据诊疗模式不同分为两组:观察组31例,男24例,女7例;年龄(53.6±12.4)岁;创面侧别:胫侧15例,腓侧16例;创面面积为28.27(23.56,37.70)cm^(2);受伤至治疗时间为(27.3±4.1)d;实施专科护士主导的医护一体化创面诊疗模式:患者入院后由医护团队共同评估患者病情、诊视伤口、确定治疗方案,出院后患者在医生随访期间,同时由专科护士主导开展延续性诊疗服务。对照组33例,男25例,女8例;年龄(51.3±14.3)岁;创面侧别:胫侧17例,腓侧16例;创面面积为27.49(17.84,40.45)cm^(2);受伤至治疗时间为(27.6±4.0)d;实施全程以医生为主导的常规诊疗模式。比较两组患者的创面愈合率、创面复发率、住院时间及患者满意度等。结果两组患者术前一般资料的比较差异均无统计学意义(P>0.05),具有可比性。观察组患者治疗后1个月内创面愈合率[83.87%(26/31)]显著高于对照组患者[60.61%(20/33)],创面愈合后6个月内复发率[0%(0/31)]显著低于对照组患者[18.18%(6/33)],住院时间[18.0(15.1,20.9)d]显著短于对照组患者[26.8(18.4,40.1)d],患者满意度[50(50,50)分]高于对照组患者[50(42,50)分],差异均有统计学意义(P<0.05)。结论与传统诊疗模式比较,专科护士主导的医护一体化创面诊疗模式在下肢慢性感染性创面伴骨外露修复中可提高患者创面愈合率,降低创面复发率,缩短住院时间,增加患者满意度。
Objective To evaluate a wound diagnosis and treatment mode with integrated medical care in the repair of chronic infectious wounds plus bone exposure at lower extremities.Methods A retrospective analysis was conducted of the 64 patients with chronic infectious wound plus bone exposure at the lower 1/3 of the leg who had been admitted to Department of Orthopedics Trauma and Microsurgery,Zhongnan Hospital of Wuhan University from January 2019 to December 2021.The patients were divided into 2 groups according to the wound diagnosis and treatment mode.In the observation group of 31 patients subjected to the wound diagnosis and treatment mode with integrated medical care led by specialist nurses,there were 24 males and 7 females with an age of(53.6±12.4)years,the wound was located at the tibial side in 15 cases and at the fibular side in 16 cases,the wound areas averaged[28.27(23.56,37.70)cm^(2)],and the time from injury to treatment was(27.3±4.1)d.Evaluation of the patient's condition,wound diagnosis and formulation of treatment protocols were performed jointly by a doctor-nurse team after the patients were admitted,and continuous diagnosis and treatment of the wounds were carried out mainly by specialist nurses during the doctors'follow-up.In the control group of 33 patients subjected to the conventional wound diagnosis and treatment mode led by doctors,there were 25 males and 8 females with an age of(51.3±14.3)years,the wound was located at the tibial side in 17 cases and at the fibular side in 16 cases,the wound areas averaged[27.49(17.84,40.45)cm^(2)],and the time from injury to treatment was(27.6±4.0)d.The 2 groups were compared in the wound healing rate,wound recurrence rate,hospitalization time and patients'satisfaction.Results There was no significant difference in the preoperative general data between the 2 groups,showing comparability(P>0.05).The observation group achieved a significantly higher wound healing rate within 1 month after treatment[83.87%(26/31)]than the control group[60.61%(20/33)],a signi
作者
杨璠
江哲珍
简超
喻爱喜
李鹏程
Yang Fan;Jiang Zhezhen;Jian Chao;Yu Aixi;Li Pengcheng(Department of Orthopaedics Trauma and Microsurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2023年第3期248-253,共6页
Chinese Journal of Orthopaedic Trauma
基金
湖北省医学领军人才工程(LJ20200405)。
关键词
护士
下肢
创伤和损伤
骨疾病
感染性
医护一体化
诊疗模式
Nurses
Lower extremity
Wounds and injuries
Bone diseases,infectious
Integrated medical care
Diagnosis and treatment mode
