Abstract:

Objective　To explore the effect of cluster nursing for patients undergoing autologous scalp tissue transplantation. Methods　This was a prospective study. According to the random number table method, 68 patients with large area burn and with scar skin as the medium thick skin donor areas treated in Zhengzhou First People's Hospital from January 2021 to December 2023 were divided into a control group and an observation group, with 34 cases in each group. There were 16 males and 18 females in the control group; they were (31.53±1.48) years old. There were 20 males and 14 females in the observation group; they were (32.12±1.32) years old. All the patients underwent autologous scalp tissue transplantation. The control group received routine nursing, and the observation group cluster nursing. The wound healing times, scores of Visual Analogue Scale (VAS) , Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and life quality (vitality, physiological function, and social function) before and after the intervention, repair effects, and incidence rates of complications were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The wound healing time of the observation group was shorter than that of the control group [(8.17±2.28) d vs. (12.56±2.34) d], with a statistical difference (t=7.835; P<0.05). The scores of VAS 1, 3, and 7 d after the intervention in the observation group were lower than those in the control group (4.54±1.14 vs. 5.95±1.25, 3.15±0.61 vs. 3.52±0.75, and 2.03±0.34 vs. 2.86±0.42), with statistical differences (t=4.860, 2.232, and 8.956; all P<0.05). After the intervention, the scores of SDS and SAS in the observation group were lower than those in the control group (31.25±3.05 vs. 39.56±2.21 and 33.23±3.72 vs. 41.56±2.35); the scores of vitality, physiological function, and social function in the observation group were higher than those in the control group (85.62±3.03 vs. 76.25±3.56, 82.14±3.76 vs. 75.65±4.15, and 85.45±2.72 vs. 80.65±2.44); there were statistical differences (t=12.865, 11.039, 11.687, 6.758, and 7.660; all P<0.05). There was no statistical difference in the incidence rate of complications between the observation group and the control group [8.82% (3/34) vs. 17.65% (6/34); χ²=0.512, P>0.05]. Six months after the intervention, the scores of itch and Vancouver Scar Evaluation Scale and scar hyperplasia rate in the observation group were lower than those in the control group [1.37±0.35 vs. 1.84±0.47, 2.05±0.71 vs. 4.31±1.53, and (20.45±4.16)% vs. (42.23±3.52)%], with statistical differences (t=4.677, 7.813, and 23.305; all P<0.05). Conclusion　Cluster nursing can promote wound healing in the middle and thick donor area of scar skin repaired by autologous scalp tissue transplantation, relieve pain, eliminate adverse emotions, improve quality of life, and reduce long-term itching and scar hyperplasia.

Key words:

Autologous scalp tissue transplantation, Cluster nursing, Effect

摘要：

目的　探究集束化护理对自体头皮组织移植术患者的效果。方法　采用前瞻性研究，选取2021年1月至2023年12月在郑州市第一人民医院收治的68例以瘢痕皮肤为中厚供皮区的大面积烧伤后整形患者作为研究对象，按照随机数字表法分为对照组（34例）和观察组（34例）。对照组男16例、女18例，年龄（31.53±1.48）岁；观察组男20例、女14例，年龄（32.12±1.32）岁。所有患者进行自体头皮组织移植术，对照组进行常规护理，观察组进行集束化护理。对比两组患者伤口愈合时间，干预前后疼痛情况［视觉模拟疼痛量表（VAS）］、心理状态［抑郁自评量表（SDS）、焦虑自评量表（SAS）］、生活质量（活力、生理功能、社交功能）、修复效果及并发症发生情况。统计学方法采用t检验、χ²检验。结果　观察组伤口愈合时间短于对照组［（8.17±2.28）d比（12.56±2.34）d］，差异有统计学意义（t=7.835，P<0.05）。干预1、3、7 d后，观察组VAS评分均低于对照组［（4.54±1.14）分比（5.95±1.25）分、（3.15±0.61）分比（3.52±0.75）分、（2.03±0.34）分比（2.86±0.42）分］，差异均有统计学意义（t=4.860、2.232、8.956，均P<0.05）。干预7 d后，观察组SDS、SAS评分均低于对照组［（31.25±3.05）分比（39.56±2.21）分、（33.23±3.72）分比（41.56±2.35）分］，活力、生理功能、社交功能评分均高于对照组［（85.62±3.03）分比（76.25±3.56）分、（82.14±3.76）分比（75.65±4.15）分、（85.45±2.72）分比（80.65±2.44）分］，差异均有统计学意义（t=12.865、11.039、11.687、6.758、7.660，均P<0.05）。观察组并发症发生率为8.82%（3/34），与对照组［17.65%（6/34）］比较，差异无统计学意义（χ²=0.512，P>0.05）。观察组干预后6个月瘙痒、温哥华瘢痕评价量表评分及瘢痕增生率均低于对照组［（1.37±0.35）分比（1.84±0.47）分、（2.05±0.71）分比（4.31±1.53）分、（20.45±4.16）%比（42.23±3.52）%］，差异均有统计学意义（t=4.677、7.813、23.305，均P<0.05）。结论　集束化护理可促进自体头皮组织移植术患者供皮区创面愈合，缓解其疼痛，消除不良情绪，提升生活质量，并降低远期瘙痒、瘢痕增生。

关键词:

自体头皮组织移植术, 集束化护理, 效果