探讨综合护理干预在小儿游离皮瓣移植术围手术期的应用效果。

选取空军军医大学第一附属医院烧伤与皮肤外科2019年1月至2020年1月下肢皮肤缺损行游离皮瓣修复手术患儿48例，设为常规护理组；2020年2月至2021年2月下肢皮肤缺损行游离皮瓣修复手术患儿48例，设为综合护理干预组。常规护理组在围手术期给予常规护理措施，综合护理干预组针对患儿术前及术后情绪、术中保温措施、术后肢体摆放及血运观察明确护理目标，实施综合护理干预。

综合护理干预组并发症发生率明显低于常规护理组(4.2% vs 16.7%，P<0.05)。综合护理干预组皮瓣成活率优于常规护理组(97.9% vs 89.5%，P<0.05)。综合护理干预组患儿及照护者依从性得分均高于常规护理组[(34.02±2.75)分vs (28.22±1.64)分，t＝5.761, P<0.05；(34.65±4.20)分vs (29.37±3.28)分，t＝5.524，P<0.05]。综合护理干预组术后24 h、术后3 d面部表情分级评分低于常规护理组[(2.41±0.23)分vs (3.26±0.19)分，t＝19.580，P<0.05；(1.78±0.11)分vs (2.74±0.18)分，t＝30.482，P<0.05]。综合护理干预组术后24 h、术后3 d焦虑自评量表评分低于常规护理组[(55.87±1.73)分vs (61.98±2.01)分，t＝15.841，P<0.05；(45.89±2.50)分vs (56.78±1.68)分，t＝24.911，P<0.05]。

综合护理干预可降低小儿游离皮瓣移植术围手术期并发症发生率，提高皮瓣成活率，改善临床预后，促进术后康复。

To explore the effect of comprehensive nursing intervention in the perioperative period of pediatric free flap transplantation.

In the Department of Burns and Skin Surgery, the First Affiliated Hospital of Air Force Military Medical University, from January 2019 to January 2020, 48 children who underwent free flap repair surgery for lower limb skin defects were selected as the routine nursing group. From February 2020 to February 2021, 48 children who underwent free flap repair surgery for lower limb skin defects were assigned to the comprehensive nursing intervention group. The routine nursing group received routine nursing measures during the perioperative period, while the comprehensive nursing intervention group clarified nursing goals based on preoperative and postoperative emotions, intraoperative insulation measures, postoperative limb placement, and blood flow observation of the patients, and implemented comprehensive nursing interventions.

The incidence of complications in the comprehensive nursing intervention group was significantly lower than that in the routine nursing group (4.2% vs 16.7%, P<0.05). The survival rate of the flap in the comprehensive nursing intervention group was better than that in the routine nursing group (97.9% vs 89.5%, P<0.05). The compliance scores of children and caregivers in the comprehensive nursing intervention group were higher than those in the routine nursing group [(34.02±2.75) vs (28.22±1.64), t=5.761, P<0.05; (34.65±4.20) vs (29.37±3.28), t=5.524, P<0.05]. The facial expression grading scores of the comprehensive nursing intervention group at 24 hours and 3 days after surgery were lower than those of the routine nursing group [(2.41±0.23) vs (3.26±0.19), t=19.580, P<0.05; (1.78±0.11) vs (2.74±0.18), t=30.482, P<0.05]. The comprehensive nursing intervention group had lower scores on the anxiety self-assessment scale at 24 hours and 3 days after surgery than the routine nursing group [(55.87±1.73) vs (61.98±2.01), t=15.841, P<0.05; (45.89±2.50) vs (56.78±1.68), t=24.911, P<0.05].

Comprehensive nursing intervention can reduce the incidence of perioperative complications in pediatric free flap transplantation, increase flap survival rate, improve clinical prognosis, and promote postoperative recovery.