Abstract:

Objective　To explore the effect of peroxide fatty acid ester wet compress combined with foam pad in the prevention and treatment of tension blisters in patients after ankle fracture surgery. Methods　One hundred and sixty-eight postoperative patients with ankle fractures admitted to Zhengzhou Orthopedic Hospital from January 2022 to April 2023 were selected for the randomized controlled trial, and were divided into 4 groups by the random number table method, with 42 cases in each group. There were 26 males and 16 females in the control group, they were (45.15±7.82) years old; there were 23 cases of type A, 14 cases of type B, and 5 cases of type C of Danis-weber. There were 24 males and 18 females in group A; they were (44.85±7.96) years old; there were 22 cases of type A, 13 cases of type B, and 7 cases of type C of Danis-weber. There were 27 males and 15 females in group B; they were (44.50±7.66) years old; there were 24 cases of type A, 14 cases of type B, and 4 cases of type C of Danis-weber. There were 25 males and 17 females in group C; they were (45.20±7.93) years old; there were 24 case of type A, 15 cases of type B, and 3 case of type C of Danis-weber. The control group were given routine methods to prevent and treat tension blisters; group A were treated with conventional methods and peroxide fatty acid ester wet compress; group B used conventional method+foam pad; group C were treated with the conventional method+fatty acid peroxide wet compress+foam pad. One-way ANOVA, non-parametric methods, and χ² test were used. Results　The incidence of tension blisters in group C was lower than that in the control group [2.38% (1/42) vs. 25.64% (10/39); χ²=9.322, P=0.002]. The affected area in group C was less than that in the control group [1 vs. 4 (2, 5); U=6.154, P=0.008]; the diameter of the largest blisters in the group C was shorter than that of the control group [2.0 cm vs. 4.2 (2.5, 5.6) cm; U=12.415, P＜0.001]. There was a statistical difference in the regression time of blisters between the 4 groups (F=3.529, P=0.021). The scores of physiological, psychological, spiritual, socio-cultural, and environmental comforts of the four groups were higher after than before the nursing; the scores of group A, group B, and group C were all higher than those of the control group; the scores of group C were higher than those of group A and group B; there were statistical differences (all P<0.05). The total satisfaction rates of group A and group C were higher than that of the control group [85.37% (35/41) and 100.00% (42/42) vs. 66.67% (26/39); χ²=3.859 and 16.676, both P<0.05]; the rate of group C was higher than those of group A and group B [100.00% (42/42) vs. 85.37% (35/41) and 83.33% (35/42); χ²=6.625 and 7.636, both P<0.05]. Conclusion　Peroxide fatty acid ester wet compress combined with foam pad in the prevention and treatment of tension blisters in patients after ankle fracture surgery is effective and ideal.

Key words:

Ankle fractures, Tension blisters, Peroxide fatty acid ester, Foam pad

摘要：

目的　探讨过氧化脂肪酸酯湿敷结合泡沫垫在踝关节骨折术后张力性水疱防治中的应用效果。方法　开展前瞻性随机对照试验。选取2022年1月至2023年4月郑州市骨科医院收治的168例踝关节骨折术后患者作为研究对象，按照随机数字表法分为4组，各42例。对照组男26例、女16例，年龄（45.15±7.82）岁，Danis-weber分型：A型23例、B型14例、C型5例；A组男24例、女18例，年龄（44.85±7.96）岁，Danis-weber分型：A型22例、B型13例、C型7例；B组男27例、女15例，年龄（44.50±7.66）岁，Danis-weber分型：A型24例、B型14例、C型4例；C组男25例、女17例，年龄（45.20±7.93）岁，Danis-weber分型：A型24例、B型15例、C型3例。对照组采用常规方法防治张力性水疱，A组采用常规方法+过氧化脂肪酸酯湿敷，B组采用常规方法+泡沫垫，C组采用常规方法+过氧化脂肪酸酯湿敷+泡沫垫，4组患者均干预至术后10 d。对比各组患者张力性水疱发生率、患处、水疱分型、最大水疱直径、水疱消退、肿胀消退及水疱愈合时间、舒适度评分、护理满意度情况。统计学方法采用单因素方差分析检验、非参数法检验、χ²检验。结果　C组张力性水疱发生率低于对照组［2.38%（1/42）比25.64%（10/39）］（χ²=9.322，P=0.002），患处少于对照组［1比4（2，5）］（U=6.154，P=0.008），最大水疱直径短于对照组［2.0 cm比4.2（2.5，5.6）cm］（U=12.415，P<0.001）。各组水疱消退时间比较，差异有统计学意义（F=3.529，P=0.021）。4组患者护理后生理、心理、精神、社会文化与环境舒适度评分均高于护理前，且护理后A组［（19.34±3.47）分、（17.51±3.18）分、（17.32±2.18）分、（19.00±3.20）分］、B组［（19.40±3.52）分、（17.69±3.21）分、（17.43±2.39）分、（19.02±3.24）分］、C组舒适度评分［（22.86±3.06）分、（20.71±3.86）分、（19.86±2.50）分、（22.48±3.86）分］均高于对照组［（16.21±3.02）分、（15.59±2.14）分、（15.82±2.20）分、（16.51±2.36）分］，C组均高于A组、B组，差异均有统计学意义（均P<0.05）。A组、C组总满意度均高于对照组［85.37%（35/41）、100.00%（42/42）比66.67%（26/39）］（χ²=3.859、16.676，均P<0.05），且C组高于A组、B组［100.00%（42/42）比85.37%（35/41）、83.33%（35/42）］（χ²=6.625、7.636，均P<0.05）。结论　过氧化脂肪酸酯湿敷联合泡沫垫在踝关节骨折术后张力性水疱防治中的效果更理想，可提高患者舒适度及护理满意度。

关键词:

踝关节骨折, 张力性水疱, 过氧化脂肪酸酯, 泡沫垫