婴幼儿先天性唇裂围手术期护理体会

唇裂是一种常见的先天性唇畸形，不仅对容貌造成严重影响，而且还不同程度地影响到患儿的生长发育。因此，无论是单侧唇裂还是双侧唇裂，外科手术是唯一的治疗方法，虽然手术方法不尽相同，但是，护理的优劣则直接影响到手术的成败。我们通过对37例唇裂患者实施有效护理，加强术前术后健康教育、心理护理、伤口护理、唇弓减张护理等，从而保证了手术的成功，医患双方满意，现将护理体会报告如下。     

小儿气管异物取出术36例围手术期护理体会

目的总结小儿气管异物取出术的围手术期护理方法和并发症防治措施,提高异物取出成功率。方法对36例复合静脉麻醉下行气管异物取出术的患儿,精心实施围手术期护理措施。回顾性分析患儿的临床资料。结果 36例患儿均将异物顺利取出,无1例行气管切开术、未发生气胸及与护理措施不当有关的发症。结论充分术前准备,熟练术中配合和术后精心管理,是提高异物取出成功率的关键。     

小儿气管异物取出术的围术期护理体会

目的总结小儿气管异物取出术的围术期护理体会。方法对31例气管异物患儿实施支气管镜异物取出术时,及时完成术前准备,术中配合并加强术后严密观察病情、保持呼吸道通畅、并发症的预防、出院宣教等护理措施。结果本组31例患儿均成功取出支气管异物。术后出现2例喉头水肿或痉挛,均经对症处理后缓解,未发生气胸及其他并发症,均痊愈出院。结论小儿气管支气管异物取出术期间,实施全面、规范护理干预,可提高手术成功率,降低并发症发生率。     

273例宫腔镜手术围术期护理体会

目的探讨宫腔镜围手术期的护理措施。方法对273例接受宫腔镜手术患者的临床资料进行回顾性分析。结果手术均顺利完成,经围术期护理配合未发生子宫穿孔、空气栓塞、TURP综合征、术后出血、感染等并发症。结论宫腔镜手术创伤小、出血少、恢复快、可保留患者的生育能力。护理人员要做好围手术期护理措施,与医师密切配合,以保障手术的顺利进行及患者的迅速康复。     

小儿疝手术围手术期舒适护理效果观察

目的观察小儿疝手术围手术期舒适护理的效果。方法对60例疝手术患儿实施围手术期舒适护理干预,观察护理效果。结果 60例患儿均顺利完成手术,平均手术时间12.82 min,平均住院时间3.62 d,术后切口均愈合良好,未发生阴囊血肿、尿潴留等并发症,家属均对护理工作满意。结论对小儿疝手术行围手术期舒适护理,可提高患儿治疗依从性,促进其早日恢复健康。     

小儿手外科的围手术期麻醉护理

目的：总结小儿手外科手术中围手术期的麻醉护理要点。方法回顾性分析2011年1月-2012年12月852例小儿手外科手术麻醉护理配合。结果全部患者顺利完成手术,无不良反应和并发症的发生。结论提高手术室护理人员对小儿患者的重视,根据小儿患者的生理、心理特点,有针对性地采取相应护理措施是确保小儿手术成功的关键。     

腹部手术围术期胃肠减压术的护理体会

正胃肠减压术是腹部手术后常用的措施,通过胃管负压吸引及虹吸原理吸出积聚于胃肠道内的气体和液体[1],以降低胃肠道内压力和张力改善胃肠壁的血液循环,有利于减少并发症的发生,而促进胃肠道功能恢复和提高手术治疗效果。2015-10—2016-04间,我们对37例实施胃肠减压术患者给予精心护理,效果满意,现将护理体会报告如下。1资料与方法1.1一般资料本组37例患者,男21例,女16例;年     

无痛人工流产术围手术期整体护理体会

目的探讨无痛人工流产术(人流术)围手术期整体护理的方法及效果。方法随机将180例接受无痛人流术的孕妇分为2组,各90例。对照组实施常规护理,观察组在对照组基础上给予整体护理措施。比较、分析2组的护理效果。结果观察组孕妇的焦虑发生率、手术时间、异丙酚用量、苏醒时间及不良反应均显著少于对照组,而护理满意度高于对照组,2组比较,差异有统计学意义(P0.05)。结论无痛人流术围手术期行整体护理措施,可有效缓解孕妇的焦虑状态,缩短手术时间,减少异丙酚用量和不良反应,提升护理质量。     

小儿腹股沟斜疝围手术期的综合护理体会

目的探讨小儿腹股沟斜疝围手术期综合护理的方法和效果。方法随机将84例小儿腹股沟斜疝分成观察组与对照组,每组42例。对照组给予常规护理,观察组采围手术期综合护理,比较2组护理效果。结果观察组阴囊水肿、牵拉痛及尿潴留的发生率明显低于对照组。对护理的满意度明显高于对照组,差异均有统计学意义(P0.05)。结论对小儿腹股沟斜疝行围手术期综合护理,可减轻患儿痛苦,提高患儿的生活质量。     

先天性唇腭裂患儿的围手术期护理

目的：先天性唇腭裂是口腔颌面部最常见的先天畸形,探讨如何加强对唇腭裂患儿的围手术期护理,以达到最理想的手术及术后康复效果。方法：统计我科2009年1月1日～2010年12月31日收治的120例唇腭裂患儿,总结围手术期护理经验。结果：所有患儿经过精心的护理、心理和康复治疗,均获得良好的治疗效果。结论：良好的围手术期护理以及心理护理是唇腭裂患儿手术成功及术后康复的重要保障。     

先天性脊柱侧弯围手术期的护理

目的:探讨先天性脊柱侧弯围手术期的护理,为以后的护理工作提供借鉴,减少术后并发症的发生。方法:术前对患儿进行心理护理、呼吸以及神经系统等方面的评估;术后给予精细护理,严密观察患儿恢复情况,进行健康指导,避免并发症。结果:35例患儿均未发生严重的并发症,均得以治愈出院。结论:先天性脊柱侧弯围术期的有效护理对患儿的康复有较大的促进作用。     

Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate

BACKGROUND: A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications. METHODS: We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold. RESULTS: The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05). CONCLUSIONS: Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.     

用医学美学的理念指导唇腭裂患儿的临床护理

目的:总结以医学美学的理念指导先天性唇腭裂患儿临床护理的经验。方法:本组患儿309例,男169例,女140例;年龄:1月~18岁,体重1.5~66Kg;单纯唇裂79例,唇裂伴腭裂181例,单纯腭裂49例。所有患者均行手术整复。主要的护理内容有:从医学美学的角度进行唇腭裂相关知识的宣教;帮助患儿及父母的心理达到平衡状态;以医学美学的理念指导常规护理操作和舒适护理;美化病房环境;出院的美学指导。结果:309例唇腭裂患儿的护理均取得了较满意的效果,唇裂患儿术后容貌明显美观;仅8例腭裂患儿发生腭瘘或复裂,其余患儿创口愈合良好,悬雍垂成形,语音明显改善。结论:以医学美学的理念指导临床护理,有助于提高唇腭裂患儿的医护质量和患者满意度,并有利于提高护理人员的美学修养。     

Our experience with the Cronin and Millard techniques for the treatment of secondary bilateral cleft lip nose

Summary Our experience with the Cronin and Millard techniques for the treatment of the secondary bilateral cleft lip nose has been evaluated by an objective photogrammetric method. The method involved uses measurements from photographs. The statistical analysis has revealed that elongation of columella, narrowing of alar bases, normalization of nasolabial angle and nostril position have been accomplished by both the Cronin and Millard techniques; there was no statistical difference between the two techniques in achieving these corrections.     

应用假体矫正单侧唇裂术后鼻孔基底凹陷畸形

目的探讨矫正唇裂术后鼻孔基底凹陷畸形的方法。方法对24例患有唇裂术后鼻唇畸形的患者进行手术,切除上唇瘢痕,重建口轮匝肌,矫正红唇凹陷,提高患侧鼻翼,在患侧的梨状孔周围用膨体雕刻成预定的形状并进行填充。结果24例患者中,有2例因出现感染而取出假体,其余效果满意。结论对于错过了牙槽骨植骨仍存在鼻孔基底凹陷的患者,在矫正鼻唇畸形的同时,可采用膨体填充患侧鼻孔基底的凹陷。     

临床护理路径在唇裂手术患者中的应用及评价

目的：探讨临床护理路径（CNP）在唇裂手术患者护理中的应用效果。方法：对110例唇裂手术的患者进行随机分组,一组纳入CNP组,另外一组按照常规护理作为对照,记录两组患者的总住院费用、住院时间及患者对护理的满意度并进行对比。结果：纳入CNP的唇裂手术患者与常规护理患者相比,平均住院日缩短,平均住院费用降低,患者满意度显著提高（P〈0．05）。结论：CNP在唇裂患者中的应用有助于降低费用,缩短住院时间,有利于护理质量的提高。     

唇腭裂1386例发病特点回顾性分析

目的：通过对唇腭裂患者临床资料进行回顾性统计分析,研究该病的发病特点,为唇腭裂的预防及治疗提供临床参考。方法：统计分析2007年1月～2010年1月手术治疗的1386例唇腭裂患者,分别从患者诊断、性别、年龄、出生地,唇腭裂裂型分布情况等方面进行回顾性调查。结果：本组病例中,单纯唇裂356例（25．69％）,唇裂合并腭裂580例（41．84％）,单纯腭裂450例（32．47％）;男809例,女577例,男：女=1．40：1;单侧唇裂伴或不伴腭裂明显多于双侧者,两者之比为5．67：1,其中左侧多于右侧（1．82：1）。结论：唇腭裂发病以唇裂合并腭裂居多,男性发病多于女性,在腭裂患者中女性发病高于男性;单侧发病多于双侧,左侧多于右侧。     

Aesthetic camouflage of bilateral cleft lip scars

Two operative scar lines remain after bilateral cleft lip repair. A method has been devised in which the two scar lines are reduced into one. The characteristics of this method include (1) an inconspicuous scar, (2) elevation of the nasal tip using the prolabium, (3) repair of the whistling deformity, (4) a natural-looking mustache, (5) formation of a pout, and (6) psychological benefits. Good results have been obtained with this method. The disadvantage of this method is the maxillary retardation. However, this does not occur in adults and can be corrected easily in children.Presented at the 7th Congress of Japanese Society of Cleft Palate, July 22, 1983; 29th Congress of Japan Society of Plastic and Reconstructive Surgery, June 12, 1986; and 9th Congress of Japan Society of Aesthetic and Plastic Surgery, November 15, 1986     

Incomplete midline cleft of the lower lip

Summary Midline clefts of the lower lip and mandible, and incomplete midline clefts of the lower lip are uncommon anomalies, with the latter being very rare. A case of incomplete midline lower lip cleft with a corresponding orbicularis oris muscle defect is present.