CAJ | 학술논문

目的：探讨糖尿病足负压封闭术后皮瓣修复患者临床路径健康宣教的效果，提高糖尿病足皮瓣移植患者健康教育掌握率。方法选择2012年1月~2013年4月在佛山市中医院骨二科糖尿病足负压封闭术后需皮瓣移植修复皮缺损的患者共60例，其中2012年1~8月采用常规健康宣教纳入的30例患者设为对照组，2012年9月~2013年4月采用临床路径健康宣教纳入的30例患者设为研究组，对两组患者的健康教育知识掌握程度、皮瓣移植成活率、护理满意度及生活质量进行比较及分析。结果研究组患者健康教育知识掌握程度(>80分者46.7%)、护理满意度(86.7%)均好于对照组(>80分者23.3%、66.7%)，研究组患者焦虑自评量表评分[(38.8±7.1)分]及抑郁自评量表评分[(40.5±6.6)分]低于对照组[(46.9±8.5)、(49.3±7.8)分]，差异有统计学意义(P<0.05)。研究组患者饮食[(4.25±0.77)分]、睡眠[(4.80±0.75)分]、疲乏[(4.26±0.71)分]、对疾病的认识[(3.78±0.62)分]及对治疗的态度[(3.89±0.73)分]得分均显著高于对照组[(3.73±0.61)、(4.07±0.52)、(3.56±0.60)、(2.98±0.55)、(3.35±0.61)分]，差异均有统计学意义(均P<0.05)。研究组患者皮瓣移植成活率(100.0%)高于对照组(86.7%)，差异有统计学意义(P<0.05)。结论糖尿病足负压封闭术后皮瓣修复患者采用临床路径健康宣教能有效提高皮瓣移植的成功率，取得较好的护理满意度，患者生活质量高。
목적：탐토당뇨병족부압봉폐술후피판수복환자림상로경건강선교적효과，제고당뇨병족피판이식환자건강교육장악솔。방법선택2012년1월~2013년4월재불산시중의원골이과당뇨병족부압봉폐술후수피판이식수복피결손적환자공60례，기중2012년1~8월채용상규건강선교납입적30례환자설위대조조，2012년9월~2013년4월채용림상로경건강선교납입적30례환자설위연구조，대량조환자적건강교육지식장악정도、피판이식성활솔、호리만의도급생활질량진행비교급분석。결과연구조환자건강교육지식장악정도(>80분자46.7%)、호리만의도(86.7%)균호우대조조(>80분자23.3%、66.7%)，연구조환자초필자평량표평분[(38.8±7.1)분]급억욱자평량표평분[(40.5±6.6)분]저우대조조[(46.9±8.5)、(49.3±7.8)분]，차이유통계학의의(P<0.05)。연구조환자음식[(4.25±0.77)분]、수면[(4.80±0.75)분]、피핍[(4.26±0.71)분]、대질병적인식[(3.78±0.62)분]급대치료적태도[(3.89±0.73)분]득분균현저고우대조조[(3.73±0.61)、(4.07±0.52)、(3.56±0.60)、(2.98±0.55)、(3.35±0.61)분]，차이균유통계학의의(균P<0.05)。연구조환자피판이식성활솔(100.0%)고우대조조(86.7%)，차이유통계학의의(P<0.05)。결론당뇨병족부압봉폐술후피판수복환자채용림상로경건강선교능유효제고피판이식적성공솔，취득교호적호리만의도，환자생활질량고。
Objective To explore the effect of clinical pathway health education in patients with diabetic foot under-went skin flap repair after vacuum sealing, improve health education master rate of patients with diabetic foot under-went skin flap repair. Methods 60 cases with diabetic foot underwent skin flap repair after vacuum sealing were select-ed from January 2012 to April 2013 in the Second Department of Orthopaedics in Foshan Hospital of Traditional Chi-nese Medicine, in which, 30 cases underwent regular health education from January to August 2012 were selected as the control group, 30 cases underwent clinical pathway health education from September 2012 to April 2013 were se-lected as the study group. The patient's health education master degree, survival rate of skin flap transplantation, nurs-ing satisfaction and quality of life in the two groups were compared and analyzed. Results The patient's health educa-tion master degree (the score higher than 80 of patients was 46.7%), nursing satisfaction (86.7%) in the study group were better than those in the control group (23.3%, 66.7%), SAS scores [(38.8±7.1) points] and SDS scores [(40.5±6.6) points] in the study group were lower than those in the control group [(46.9±8.5), (49.3±7.8) points], there were signifi-cant differences between the two groups (P< 0.05). The patient's scores of eating [(4.25±0.77) points], sleeping [(4.80±0.75) points], fatigue [(4.26±0.71) points], awareness of the disease [(3.78±0.62) points] and attitudes to treatment [(3.89±0.73) points] in the study group were higher than those in the control group [(3.73±0.61), (4.07±0.52), (3.56±0.60), (2.98±0.55), (3.35±0.61) points], there were significant differences between the two groups (P<0.05). The patient's sur-vival rate of skin flap transplantation in the study group (100.0%) was higher than that in the control group (86.7%), there was a significant difference between the two groups (P<0.05). Conclusion The clinical pathway health education in patients with diabetic foot underwent skin flap re-pair after vacuum sealing can effectively improve the survival rate of skin flap transplantation, obtain better nursing satisfaction and higher quality of life.