改良Mohler法先天性单侧唇裂修复及同期鼻畸形矫正术围手术期护理

目的总结26例运用改良Mohler法进行先天性单侧唇裂修复及同期鼻畸形矫正术患儿的围手术期护理要点,为临床该类整形患儿护理专业化提供借鉴。方法对2018年1月~2019年12月在我院接受改良Mohler法先天性单侧唇裂修复及同期鼻畸形矫正术的26例患儿及家长实施围手术期护理,具体措施包括术前患儿家长心理护理和健康宣教,术后患儿口腔护理及饮食指导、皮瓣观察及护理、呼吸道护理、健康宣教、心理疏导等。结果 26例改良Mohler法先天性单侧唇裂修复及同期鼻畸形矫正手术均顺利完成,术后切口愈合良好,患儿鼻唇部线距均得到明显改善,双侧唇高、唇长、鼻孔宽度对称,术后3个月随访,4例存在裂隙侧唇峰上移,唇高不足,术后6个月随访,畸形无加重,上唇缩短症状明显改善,患儿家属对手术效果满意,护理满意度100%。结论改良Mohler法单侧唇裂修复及同期鼻畸形矫正术可有效修复先天性单侧唇裂鼻畸形,恢复鼻唇部正常三维形态,围手术期的科学护理对手术顺利完成和保证修复效果至关重要。

Perioperative nursing of congenital unilateral cleft lip repair with modified Mohler method and simultaneous correction of rhinoplasty

Objective Summarize the key points of perioperative nursing of 26 children with congenital unilateral cleft lip repair and concomitant rhinoplasty correction using modified Mohler method,and provide reference for the clinical specialization of nursing of this type of plastic children.Methods Perioperative care was given to 26 children and parents who underwent congenital unilateral cleft lip repair and simultaneous nasal deformity correction in our hospital from January 2018 to December 2019.The specific measures include the parents of children before surgery.Psychological nursing and health education,postoperative oral care and diet guidance for children,skin flap observation and nursing,respiratory care,health education,psychological counseling,etc.Results Modified 26 cases of congenital unilateral cleft lip repair and simultaneous nasal deformity correction were successfully completed with improved Mohler method.The postoperative incision healed well,and the nasal-lip line spacing was significantly improved.The bilateral lip height,lip length,and nostril width were symmetrical.After 3 months of follow-up,4 cases had fissure-side lip peak shift and insufficient lip height.At 6-month follow-up,the deformity did not worsen,and the symptoms of shortening of the upper lip were significantly improved.The family members of the children were satisfied with the operation results and nursing satisfaction.100%.Conclusion Modified Mohler method for unilateral cleft lip repair and simultaneous nasal deformity correction can effectively repair congenital unilateral cleft lip deformity and restore the normal three-dimensional shape of the nasolabial.Perioperative scientific care is crucial to the successful completion of the operation and to ensure the repair effect.