CAJ | 학술논문

目的:探讨深Ⅱ°以上烧伤合并肩关节离断手术的护理配合.方法:调查5例全身多处深Ⅱ°以上烧伤合并一侧腋下神经、血管断裂和缺损的患者,行肩关节离断手术+清创术及扩创+游离皮瓣植皮术,并给予精心的护理配合.结果:5例患者中4例肩关节离断端端愈合良好.5例患者植皮皮片完全成活,1例肩关节离断端有大量血凝块积聚及坏死的肌肉组织,经清创处理后顺利愈合.结论:深Ⅱ°以上烧伤合并肩关节离断手术由于其病情危重,创伤面积大,手术难度高,手术次数多,手术时间长及术后肢体残缺等特点,在进行肩关节离断+清创术和扩创+游离皮瓣植皮手术时必须做好大量物品、器械及急救物品的准备,熟练配合手术操作,随时做好抢救准备,术后做好创面的加压包扎,防止感染,全程进行心理疏导,消除疑虑,减轻患者压力,增强患者对手术的信心,对生命的珍惜.
목적:탐토심Ⅱ°이상소상합병견관절리단수술적호리배합.방법:조사5례전신다처심Ⅱ°이상소상합병일측액하신경、혈관단렬화결손적환자,행견관절리단수술+청창술급확창+유리피판식피술,병급여정심적호리배합.결과:5례환자중4례견관절리단단단유합량호.5례환자식피피편완전성활,1례견관절리단단유대량혈응괴적취급배사적기육조직,경청창처리후순리유합.결론:심Ⅱ°이상소상합병견관절리단수술유우기병정위중,창상면적대,수술난도고,수술차수다,수술시간장급술후지체잔결등특점,재진행견관절리단+청창술화확창+유리피판식피수술시필수주호대량물품、기계급급구물품적준비,숙련배합수술조작,수시주호창구준비,술후주호창면적가압포찰,방지감염,전정진행심리소도,소제의필,감경환자압력,증강환자대수술적신심,대생명적진석.
Objective:To study nursing cooperation of disarticalation of shoulder with deepⅡ°above burn patient. Methods:Investigates 5 example whole bodies place to be deep muchⅡ° above burn patient merges one side armpit nerve, the blood vessel break and the damage, the silk thread business shoulder joint to breaks the surgery + epluchage and expands creates + the dissociation skin petal skin grafting nursing coordination method. Results: 4 example patients shoulder joint to breaks the neat cicatrization to be good. 5 example patients graft skin Pi Pian to survive completely, 1 example shoulder joint to breaks the end to have the massive blood clot agglomeration and necrosis muscular tissue, after creates processing clear the smooth cicatrization. Conclusion:The depthⅡ° above burn patient gathers shoulder to shoulder the joint to break the surgery because its condition was seriously injured, the wound area was big, the surgery difficulty is high, the surgery number of times are many, surgery time long and technique hind legs body incomplete and so on characteristics, when carries on the shoulder joint to break + the epluchage and expands creates + the dissociation skin petal skin grafting surgery must complete the massive goods, the instrument and the first aid goods preparation, coordinates the surgery to operate skilled, prepares for rescue as necessary, after the technique completes the injured area the compression wrap, prevents the infection, the entire journey carries on psychological unblocking, dispels the anxiety, reduces the patient pressure, strengthens the patient to the surgery confidence and treasuring the life.