循证护理在多组织组合移植修复四肢创伤术后预防血管危象中应用-循证护理在多组织组合移植修复四肢创伤术后预防血管危象中应用.doc

循证护理在多组织组合移植修复四肢创伤术后预防血管危象中应用*循证护理在多组织组合移植修复四肢创伤术后预防血管危象中应用[摘要] 目的 将循证护理应用在多组织组合移植修复四肢创伤术后血管危象预防中，与传统护理效果进行比较。方法 对16例多组织组合移植修复四肢创伤术后血管危象预防中应用循证护理方法采取个体化措施，与传统护理效果进行比较。结果 16例患者无一例发生血管危象，组合移植组织全部成活。结论 循证护理是一种优于传统护理的工作方法和护理理念，可为患者提供更优质的护理服务。 [关键词] 循证护理；多组织组合移植；四肢创伤；血管危象 [中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701（2011）35-90-02 The Postoperative Application of Evidence-based Nursing in Prevention of Vascular Crisis after a Multi-tissue Combined Graft for Limb Trauma HUANG Sukun1 CHEN Fulian1 DONG Lele1 SUN Yabo2 FAN Qing1 1.The Second Department of Orthopedics，the First Affiliated Hospital of Baotou Medical College，Baotou 014010，China; 2.Department of Nursing, the First Affiliated Hospital of Baotou Medical College，Baotou 014010，China [Abstract] Objective To apply the evidence-based nursing in prevention of vascular crisis after a multi-tissue combined graft for limb trauma，and results were compared with those of the traditional care. Methods The evidence-based nursing in prevention of vascular crisis after a multi-tissue combined graft for limb trauma were applied and individual care measures were adopted in 16 cases of patients，and results were compared with those of the traditional care. Results No case of vascular crisis occurred in the 16 patients，and all of the combined transplanted tissues survived. Conclusion Evidence-based care is work method or nursing philosophy that is superior to those of traditional care，can provide better care for patients. [Key words] Evidence-based care；Multi-tissue combined graft；Limb trauma；Vascular crisis 随着显微外科技术的不断进步，极大地推动了多组织组合移植术在临床上的应用和发展。多组织组合移植术不只依赖于娴熟的手术技术操作，还取决于科学合理的围手术期护理。自2007年1月，我科成立循证小组并将循证护理[1]应用于多组织组合移植修复四肢创伤术后血管危象的预防中。 1 对象与方法 1.1 研究对象 2007年2月～2009年11月多组织组合移植修复四肢创伤术患者16例，男13例，女3例，年龄18～53岁，平均33岁，其中下肢4例，上肢12例。 1.2 研究方法 1.2.1 循证问题 病房温湿度、患者心理状态（焦虑、抑郁）、疼痛、吸烟、体位、静脉滴注速度、饮食与便秘、监测技术。 1.2.2 检索文献资料，寻求实证，评价研究证据的有效性和可操作性。 1.2.3 根据研究证据，采取个体化循证措施，并与传统护理效果进行比较。（1）病室温度、湿度 寒冷可使全身小血管收缩，导致远端供血不足