乳腺癌改良根治术后两种皮瓣护理方法的对照研究

目的:探讨不同皮瓣护理方法对乳腺癌改良根治术后皮瓣恢复和患者舒适度的影响.方法:将158例患者随机分为对照组97例和实验组61例,对照组采用传统加压包扎皮辩护理,实验组采用不加压皮瓣护理.比较两组术后前3 d引流量、拔管天数、皮下积液、皮瓣坏死、切口愈合、皮肤损伤程度及舒适度评分等的差异.结果:两组术后拔管天数、皮下积液、皮瓣坏死及切口1期愈合的发生率比较均无显著性差异(P>0.05).但实验组术后前3 d的引流量明显少于对照组(P<0.01);患者术后24 h及72 h舒适度评分均明显高于对照组(P<0.01);术后术野以外皮肤红肿发生率明显低于对照组(P<0.01),皮肤水泡发生率低于对照组(P<0.05).结论:无加压的皮辩护理可取得与传统加压包扎相同的疗效,且具有操作简单、患者感觉舒适、便于观察等优点.

A comparative study on the two kinds of methods of nursing care of skin flap after modified radical mastectomy

Objective: To explore the impact of different methods of nursing care of skin flap on flap recovery and the pa-tients'comfort after modified radical mastectomy. Methods: 158 patients were randomly divided into control group (n=97) and experimental group (n=61). The traditional pressurized bandaging was used in control group and non -pressurized bandaging was applied in experimental group, comparing the amount of drainage, the days of extubation, subcutaneous fluid collection, skin flap necrosis, wound healing, degree of skin lesions and the scoring of patient's comfort of the first 3 days after modified radical mastectomy. Results: No significant differences were found in the comparison of the days of extubation, subcutaneous fluid col-lection, skin flap necrosis and phase Ⅰ wound healing between the two groups P>0.05) ; however, the amount of drainage the first 3 days after operation was less in experimental group than that in control group (P<0.01) ; the scores of the patient's com-fort in 24 hours and 72 hours after operation were significantly higher in experimental group dum that in control group (P < 0.01) ; the incidence of skin irritation outside the surgical field and incidence of skin blisters were significantly lower in experi-mental group than that in control group (P<0.01, P<0.05). Conclusion: The non - pressurized bandaging can achieve the same effect in nursing care of skin flap compared with the traditional pressurized bandage, with the advantages of simple opera-tion, more comfort of patients and easy observation.