头颅包扎固定帽应用于神经外科术后包扎的疗效评价

摘要

目的 探讨头颅包扎固定帽应用于神经外科术后包扎的临床护理疗效.方法 回顾性分析2015年12月-2016年7月武警总医院神经血管外科收治的神经外科手术患者106例,按是否应用头颅包扎固定帽的分成两组,其中观察组为54人和对照组为52人,观察组应用头颅包扎固定帽,而对照组采用传统纱布加弹力绷带的方法;从皮下积液发生率、手术切口皮缘坏死率、患者舒适度情况(Zung,SAS评分)、切口愈合情况以及非计划换药次数等方面探讨不同的术后包扎方式的优劣.结果 本研究中对照组的皮下积液发生率为7.4%,明显高于观察组的1.9%,对照组切口皮缘坏死率为5.6%,观察组皮缘坏死率为0,差异有统计学意义(P<0.05),术后第3天两组分泌物菌拭子培养的阳性率,对照组的患者舒适度情况平均为(47.6±1),明显高于观察组(54.8± 3),对照组的术后疼痛评分平均为(3.4±0.7)分,明显高于观察组(4.5±05)分,差异有统计学意义(P<0.05)分;换药次数、更换枕套次数也较多,差异有统计学意义(P<0.05)分.结论 头颅包扎固定帽降低了患者术后皮下积液发生率;有效的保护了手术切口;增加了术后患者加压包扎的舒适度;减少了换药次数,提高了医护的工作效率,值得临床推广.%Objective To investigate the clinical nursing efficacy of head bandage caps used in patients following neurosurgeries. Methods We retrospectively analyzed 106 patients with stroke admitted to Neurovascular Surgery Department of General Hospital of Armed Police Forces between Dec 2015 and Jul 2016.The patients were divided into treatment group (54 cases) and control group (52 cases). Head bandage caps and traditional dressings of gauze with elastic bandage were used for the two groups respectively.We discussed about the advantages and disadvantages of different postoperative dressing by comparing the incidence rate of subcutaneous effusion, incision edge necrosis rate,patient comfort scores(Zung,SAS scores),incision healing and unexpected dressing changes.Results There were statistically significant differences between the two groups in terms of subcutaneous effusion incidence rate(1.9% for the treatment group and 7.4% for the control group,respectively)and incision edge necrosis rate(0% for the treatment group and 5.6% for the control group, respectively,P<0.05).Both patient comfort scores (control group 47.6 ± 1;treatment group 54.8 ± 3) and postoperative pain scores (control group 3.4 ± 0.7; treatment group 4.5 ± 05) are significantly higher in the control group (P<0.05). Besides, more unexpected dressing and pillowcase changes were observed in the control group. Conclusion Head bandage caps can help reduce the incidence of subcutaneous effusion, protect the incision, improve patients'comfort, reduce dressing changes and improve staff's working efficiency.They are worth of clinical popularization.