不同药物组合对断指再植患者的疗效比较和护理学干预

目的：探讨不同药物组合对断指再植患者的疗效，以及早期不良反应的护理干预效果。方法：选取2009年1-12月患者100例作为A组，采用罂粟碱＋冬眠合剂Ⅰ号＋尿激酶＋抗生素治疗；2010年1-12月患者100例作为B组，采用冬眠合剂Ⅰ号＋尿激酶＋抗生素治疗，两组均对药物不良反应早期护理干预。结果：A组和B组患者术后镇痛、镇静效果比较差异无统计学意义（P＞0.05）。 A组再植指毛细血管的血运状况明显优于B组、血管危象发生率低于B组；断指成活率（96.0%）显著高于B组（90.0%）（P＜0.05）。结论：两种不同的药物组合均具有确切的镇痛镇静效果，其中采用罂粟碱＋冬眠合剂Ⅰ号＋尿激酶＋抗生素治疗能有效预防与缓解血管危象发生，提高断指成活率，但不良反应也较多，早期有效的护理干预可以减少这些不良反应，提高患者舒适度，从而增强患者对治疗和护理的依从性。

Comparison of efficiency between two different drug combinations after replantation of severed fingers and their early nursing intervention

Objective： To evaluat e the efficacy of different drug combinations to treat the patients with replantation of sev-ered fingers and the adverse reactions during the early nursing intervention. Methods：From January 2009 to December 2010, 200 patients with replantation of severed fingers were enrolled into the study and were divided into two groups. 100 patients from January to December 2009, including group A,were treated with papaverine plus hibernationI and urokinase plus an-tibiotic. The other 100 patients from January to December 2010, as group B,were treated with hibernation I and urokinase plus antibiotic. Results：There were no significant differences between group A and B regarding the postoperative analgesia and sedation（P〉0.05）. The capillary blood supply of the replanted fingers in group A was significantly better than that in group B. The incidence of vascular crisis was lower in group A than that in group B. The average survival rate of the severed fingers was 96% in group A, which was significantly higher than that in group B（90%）（P〈0.05）. Conclusions： Both of the drug combinations have significant analgesic and sedative effects. Treatment of papaverine plus hibernationI and urokinase plus antibiotichas can effectively prevent and relieve the vascular crisis as well as increase the success rate of replantation. Howev-er, this kind of combination also induces some adverse drug reactions. The early nursing care and intervention should reduce the adverse reactions and increase the comfort degree of patients, thus improving the patients’ compliance.