网状钛合金钢板修复胸壁缺损围手术期护理

目的总结应用网状钛合金钢板修复胸壁缺损围手术期护理要点,为临床提供借鉴。方法对应用网状钛合金钢板修复胸壁缺损的14例患者实施系统化术前健康宣教、心理疏导、呼吸道和皮肤准备;术中协助患者摆放手术体位,协助麻醉及复苏;术后密切观察生命体征的同时规范引流管管理,严格执行无菌护理技术,控制切口感染,预防皮下积液、积气、肺不张、肺部感染等并发症的发生,促进皮瓣存活,切口愈合,患者疼痛护理等;做好出院指导和定期随访,及时指导院外自我护理。结果所有患者均顺利完成手术,在科学护理措施保障下,未出现气胸、反常呼吸、切口及肺部感染等严重并发症,2例出现皮下脂肪液化、炎性反应,1例痰液不易咳出,血氧饱和度低于94%,经对症护理后,均明显改善,最终切口均Ⅰ期愈合,顺利出院。随访2年,均未发生排异反应、固定不牢等情况,患者对修复效果满意。结论网状钛合金钢板具有良好的生物相容性,用于修复胸壁缺损效果明显,但术后并发症较多,实施科学有效的围手术期护理可有效降低或预防术后并发症的发生,减轻患者疼痛,促进康复,对提高患者生存质量具有重要意义。

Perioperative nursing of repairing chest wall defect with mesh titanium alloy plate

Objective Summarize the perioperative nursing points of the application of mesh titanium alloy plate to repair the chest wall defect,and provide reference for clinical.Methods Systematic preoperative health education,psychological counseling,respiratory tract and skin preparation were performed in 14 patients with anterior mesh titanium alloy plate repairing chest wall defects;intraoperative assistance in patient placement,assisted anesthesia and resuscitation;close observation of vital signs after operation At the same time standard drainage tube management,strict implementation of aseptic care technology,control of wound infection,prevention of complications such as subcutaneous effusion,gas accumulation,atelectasis,lung infection,promote flap survival,incision healing,patient pain care Etc.;discharge guidance and regular follow-up,and promptly guide self-care outside the hospital.Results All patients successfully completed the operation.Under the protection of scientific nursing measures,there were no serious complications such as pneumothorax,abnormal breathing,incision and pulmonary infection.In 2 cases,subcutaneous fat liquefaction and inflammatory reaction occurred,and 1 case was difficult to cough up.The oxygen saturation was less than 94%.After symptomatic care,the improvement was obvious.The final incision healed in the first stage and was discharged smoothly.After 2 years of follow-up,no rejection,fixation,etc.occurred,and the patient was satisfied with the repair effect.Conclusion Reticulated titanium alloy steel plate has good biocompatibility,and it has obvious effect on repairing chest wall defect,but there are many postoperative complications.Implementing scientific and effective perioperative nursing can effectively reduce or prevent postoperative complications and reduce Patients with pain and promote rehabilitation are of great significance to improve the quality of life of patients.