先天性小耳畸形并外耳道闭锁一期成形和外耳道重建术中配合

目的:探讨先天性小耳畸形并外耳道闭锁一期耳廓成型和外耳道重建术中的手术配合方法。方法:2007年1月～2012年5月我院开展一期耳廓成形和听力重建术患者62例(66耳),均为先天性耳廓畸形伴外耳道闭锁、听骨链畸形、重度传导性耳聋。一期手术包括耳廓成形、外耳道重建、中耳重建手术。术中配合要点包括巡回护士术前对患儿进行针对性的心理护理,充分的物品准备,熟悉手术步骤,为患者摆放舒适、恰当体位,密切监护生命体征,保持引流管位置的正确及通畅;术中器械护士严格执行无菌技术,积极、密切的配合等。结果:62例(66耳)小耳畸形患者手术顺利,耳廓成形、中耳重建术后耳廓埋置于皮下,外形良好,耳廓和外耳道口位置接近正常,未出现护理差错,大部分患者术后耳廓外形及听力获得改善。结论:先天性耳廓畸形并外耳道闭锁手术风险较大,难度较高,术中与手术医师熟练的手术配合,有效的手术间管理,严格的无菌操作,是手术成功的重要保证。

Cooperation for the one-stage auricular and external auditory canal reconstruction surgery in the patients of congenital microtia and aural atresia

Objective ： To discuss the cooperate methods of the one - stage auricular and external auditory canal reconstruction surgery in the patients of con- genital microtia and aural atre_sia. Methods：Summarized the 62 cases （66 ears） of one - stage auricular and external auditory canal reconstruction surgery in the patients of congenital microtia and aural a~esia in our hospital from January 2007 to May 2012 ,whose diseases consisted of congenital microtia and exter- nal aural atresia, ossicular chain deformity and severe conductive hearing loss. The one - stage surgery consisted of auricular, external auditory canal and mid- die ear reconstruction. Key points of cooperating with the doctors consists of psychological nursing for the padetric patients by the circulating nurse preopera- tive, preparation of the equipments, getting familiar with the operation procedures, setting the patients at comfort position, monitoring of the vital signs, drai- ning of the drainage tubes. Moreover, during the operation the instrument nurse should executive the aseptic technique strictly. Results：All of the 62 cases （66 ears） accepted operation successively. Auricular reconstruction were buried under the skin with nice outline form and external auditory canal presented nice appearance. No mistake happened in the nursing procedures and most of the auricular form and acoustic sensibility got improved. Conclusion ： One - stage auricular and external auditory canal reconstruction surgery in the patients of congenital microtia and aural atresia is a high risk operation. Skilled coop- eration with the doctors during the operation, effective management of the operatin room, strict aseptic operation are important factors of the success of the operation.