The application of refined nursing in the prevention of vascular crisis after finger replantation
精细化护理在断指再造术后血管危象预防中的应用

摘要

目的 探讨精细化护理在断指再造术后血管危象预防中的应用效果，为临床护理方案优化提供参考。方法 选取2025年2月-2025年10月收治的32例断指再造手术患者，随机分为观察组（常规护理+精细化护理）与对照组（常规护理）各16例，对比两组血管危象发生率、断指再植成活率、舒适度（general comfort questionnaire, GCQ）评分、断指血运指标及生活质量（the 36-item short form health survey，SF-36）评分。其中断指血运指标包括血流阻力指数（resistance index, RI）、血管管径及平均血流速度（mean flow velocity, VM）。结果 观察组断指再植成活率96.88%，高于对照组78.13%（P>0.05）；血管危象总发生率12.50%，低于对照组37.50%（P<0.05）。干预后,观察组GCQ中心理健康（22.69±1.95）分、生理舒适度（24.18±2.51）分、环境舒适度（24.60±2.01）分、社会文化舒适度（20.84±2.00）分均高于对照组；断指血管管径（0.12±0.01）cm、VM水平（6.37±0.91）cm/s高于对照组，RI水平（0.65±0.14）低于对照组（P<0.05）；SF‑36中生理功能（68.11±4.34）分、精神健康（66.10±3.73）分、机体疼痛（66.01±3.51）分、总体健康（63.25±3.00）分均显著高于对照组（P<0.05）。结论 精细化护理可有效降低断指再造术后血管危象发生风险，提升再植成活率，改善患指血运状态，提高患者舒适度与生活质量，值得在临床推广应用。

Abstract

Objective To explore the application effect of refined nursing in preventing vascular crisis after finger replantation surgery and provide reference for optimizing clinical nursing plans.
Methods Thirty-two patients who underwent finger replantation surgery from February 2025 to October 2025 were selected and randomly divided into an observation group (routine nursing + refined nursing) and a control group (routine nursing), with 16 patients in each group. The incidence of vascular crisis, finger replantation survival rate, comfort level (General Comfort Questionnaire, GCQ) scores, finger blood circulation indicators, and quality of life (The 36-Item Short Form Health Survey, SF-36) scores were compared between the two groups. The finger blood circulation indicators included Resistance Index (RI), vascular diameter, and Mean Flow Velocity (VM).
Results The replantation survival rate of the severed fingers in the observation group was 100%, higher than 81.24% in the control group（P>0.05）; the total incidence of vascular crisis was 12.50%, lower than 37.50% in the control group (P<0.05). After intervention, the observation group scored higher than the control group in terms of GCQ psychological health (22.69±1.95), physical comfort (24.18±2.51), environmental comfort (24.60±2.01), and sociocultural comfort (20.84±2.00); the diameter of severed finger blood vessels (0.12±0.01) cm and VM level (6.37±0.91) cm/s were higher than those in the control group, while RI level (0.65±0.14) was lower (P<0.05); SF-36 scores for physical functioning (68.11±4.34), mental health (66.10±3.73), bodily pain (66.01±3.51), and overall health (63.25±3.00) were significantly higher than those in the control group (P<0.05).
Conclusion   Refined nursing can effectively reduce the risk of vascular crisis after finger replantation, improve the survival rate of the graft, enhance blood circulation in the affected finger, and increase patient comfort and quality of life. It is worthy of clinical promotion and application.