摘要
目的总结口腔黏膜游离移植尿道重建术治疗复杂尿道下裂患儿围手术期护理措施,观察其护理效果。方法选取2017年1月-2018年9月在南阳市某三甲医院接受口腔黏膜游离移植尿道成形术的37例复杂性尿道下裂患儿。年龄2-12岁,平均(6.37±2.19)岁,均采用一期游离口腔黏膜并移植至阴茎腹侧缺损尿道处,待移植黏膜存活后,行二期尿道卷曲成形术。术前给予患儿及其家属心理护理、口腔及会阴准备护理,术后给予切口及生命体征观察和体位护理、口腔护理、会阴护理、出院指导。结果本组37例复杂尿道下裂患儿,一期口腔黏膜移植存活35例,黏膜移植存活率为94.59%,术后并发尿瘘2例,发生率为5.41%,并发尿道狭窄1例,发生率为2.70%,经二次修复和尿道扩张后均治愈。术后随访3-20个月,尿道均通畅,患儿及家属对疗效和整形外观满意,护理满意度为100%。结论口腔黏膜游离移植尿道重建术修复复杂尿道下裂效果明显,配合科学围手术期护理支持,可明显促进移植粘膜存活,降低术后并发症发生率,保证修复效果。
Objective Summarize the perioperative nursing measures of free oral mucosal transplantation for urethral reconstruction in children with complicated hypospadias,and observe its nursing effect.Methods 37 children with complicated hypospadias who underwent free oral mucosal transplantation urethroplasty in a third-class hospital in Nanyang from January 2017 to September 2018 were selected.Age 2-12 years old,average(6.37±2.19)years old,all used the first-stage free oral mucosa and transplanted to the penis ventral defect urethra,after the transplanted mucosa survived,the second-stage urethral crimping angioplasty was performed.Preoperative psychological care for children and their families,oral and perineum preparation care,postoperative incision and vital signs observation,postural care,oral care,perineal care,and discharge guidance.Results In this group of 37 children with complex hypospadias,35 survived the first-stage oral mucosal transplantation,the survival rate of mucosal transplantation was 94.59%,2 cases complicated with urinary fistula after operation,the incidence was 5.41%,and 1 case complicated with urethral stricture,the incidence was 2.70%were cured after the second repair and urethral dilation.After 3-20 months of follow-up,the urethra was unobstructed,the children and their family members were satisfied with the curative effect and appearance of plastic surgery,and the nursing satisfaction was 100%.Conclusion Free oral mucosal transplantation for urethral reconstruction has obvious effects in repairing complex hypospadias.With scientific perioperative nursing support,it can significantly promote the survival of transplanted mucosa,reduce the incidence of postoperative complications,and ensure the repair effect.
作者
刘冉
余博
朱丽
LIU Ran;YU Bo;ZHU Li(Nanyang Central Hospital,Henan Province,473000,China)
出处
《中国医疗美容》
2021年第4期112-115,共4页
China Medical Cosmetology
