股薄肌皮瓣修复直肠癌腹会阴切除术后会阴缺损的护理

Nursing Care of Repair of Perineal Defect by Abdominoperineal Resection for Rectal Careinama with Gracilis Myocutaneous Flap

目的探讨采用带蒂股薄肌肌皮瓣Ⅰ期修复直肠癌腹会阴切除术后会阴部缺损的临床特点,总结手术前后的护理措施.方法对2001年7月～2004年7月在我院行腹会阴切除术后接受了股薄肌肌皮瓣Ⅰ期移植会阴部缺损修复术的7例患者进行护理,观察术后并发症发生及切口愈合情况.结果7例患者术后无切口裂开、切口脓肿或肠梗阻等并发症,术后平均17d会阴部切口Ⅰ期愈合出院,B超会阴部检查均无明显积液.结论采用带蒂股薄肌皮瓣Ⅰ期修复直肠癌腹会阴切除术后会阴部的缺损,效果理想.术后对移植皮瓣以及创面引流的精心护理是减少手术并发症的有效措施.

Objective To discuss the clinical features of reconstruction of perineal wound with Gracilis myocutaneous flap following abdominoperineal resection for rectal carcinoma, and to summarize the key points of nursing care for patients undergone such surgery. Methods From July 2001 to July 2004, 7 patients with rectal carcinoma treated in Cancer Hospital of Fudan University underwent abdominoperineal resection and immediate reconstruction with Gracilis myocutaneous flap. Patients were monitored in the department of abdominal surgery, complications and healing of the perineal wounds were closely observed. Results No patient suffered from wound dehiscence, abscess or ileus. The average healing time of perineal wound was 17 days. All patients were discharged from the hospital without abnormal, fluid accumulation in the perineum. Conclusion Immediate perineal reconstruction using Gracilis myocutaneous flap following proctectomy for rectal carcinoma significantly reduces the incidence of complication associated with perineal wound closure. Nursing care of Gracilis flap and wound drainage is important in the course of postoperative recovery.