10例先天性巨痣患儿行手术切除的围术期护理

总结先天性巨痣患儿手术切除治疗的围术期护理经验。10例先天性巨痣患儿,利用刃厚皮片切削法治疗7例,使用扩张器埋植、扩张皮瓣转移切除修复法治疗2例,1例使用刃厚皮片切削法＋扩张器埋植、扩张皮瓣转移切除修复法综合治疗。做好患儿及其家属围术期心理护理,以纠正患儿不良的心理状态、积极配合手术;由于创面面积大、边缘不规整,做好术区备皮;术后3～5 d为渗液出现的高峰期,注意患者渗液量和颜色;观察患儿扩张皮瓣和转移皮瓣的血运情况,监测皮瓣指压反应时间;做好扩张器注水护理,每次生理盐水注入20～40 ml,以不引起患儿疼痛等不适症状为宜;由于患儿的治疗周期长,做好治疗间隔的出院期间的出院治疗。本组患儿均取得了满意的治疗效果。

The Peri-operative Nursing of 10 Children Undergoing Excision of Congenital Giant Birthmarks

The author in this paper summarizes her peri-operative experience in nursing children undergoing excision of congenital giant birthmarks. Of the 10 children undergoing excision of congenital giant birthmarks, 7 were treated with slice-by-slice excision of thick skin, 2 with excision and repairing of embedded and stretched flaps with dilator and 1 with the combined methods. In nursing, the nurses should manipulate the mental care for the children and their families so that they were cooperative, conduct skin preparation due to large-size incision and irregular edges, pay attention to volume and color of effusion at the peak time 3-5 days after operation, observe blood circulation at extended and transferred flaps and monitor reaction time of flap finger pressure, pay attention to the care at allusion of dilaotor （each time at 20-40 ml of saline, depending on if they could feel unsatisfactory）, and finally attach importance to the treatment after discharge. As a result, the therapeutic effect was satisfactory for all the treated children.