喉癌切除转门肌皮瓣喉重建术50例围手术期护理观察

作者对50例喉癌切除、应用转门肌皮瓣喉重建术的患者进行围手术期临床护理观察，发现术前1d备皮、肥胖颈短及二次手术患者术后易出现皮下感染、咽瘘、皮瓣坏死或皮缘坏死．手术时间超过4h，行颈廓清及喉腔、下咽重建术，术中止血不彻底的患者并发症明显增多；术后局部包扎过紧，引流不畅．头部后仰角度偏大，术后出血的患者同样会导致上述并发症，使手术失败。通过观察，作者提出了针对性地术前、术中、术后护理对策。

Observation of Pre-and Post-operation Care on Laryngeal Reconstruction with Rool-door Muscle-skin Flap for 50 Cases of Laryngectomy

An observation was made of pre- and post-operative care for 50 patients who underwent laryngecto-my and were restored with the rool-door muscle-skin flap. The results were as follows: Subcutaneous infection,pharyngeal fistula, flap or marginal necrosis readily occurred in the patient whose skin was prepared on the lastday before the operation, who was obese with short neck or who had the operation for the second time. If theoperation lasted more than 4 hours,more complicati ons would develop in the patient who had radical neck dis-section or laryngeal reconstruction; the complications would also occur in the patient who had postoperativehaemorrhage or whose wound tightly dressed or inadequately drained. Some strategies were suggested to dealwith these preoperative and postoperative complications.