游离腓骨皮瓣移植修复颌面部组织缺损的护理

Nursing of Patients Receiving Maxillofacial Reconstructive Operation with Free Fibula Flap

目的总结游离腓骨皮瓣移植修复颌面部缺损的护理。方法对2006年1月至2009年12月行下颌骨部分切除及腓骨皮瓣移植修复术的8例患者的临床资料及护理措施进行回顾性总结。结果 8例患者血管吻合成功,骨皮瓣和皮瓣均成活良好。术后随访6~18个月,无一例患者因取腓骨而影响下肢日常活动;其中7例患者可正常进食,面部外形恢复满意,术后语音交流清晰,1例放射性骨髓炎患者因放疗导致张口困难。结论应用腓骨皮瓣移植修复颌面部缺损具有较好的疗效,认真做好术前准备、术后严密观察皮瓣情况、采取针对性护理措施是手术成功的重要环节。

Objective To summarize the nursing experience of patients receiving maxillofacial reconstructive operation with free fibula flap.Methods The clinical data and nursing measures of 8 patients who received partial resection mandible and maxillofacial reconstructive operation with free fibula flap from January 2006 to December 2009 were summarized retrospectively.Results Successful anastomosis were achieved in 8 patients and the bone and skin flaps survived.The patients were followed up for 6 to 18 months and none of them suffered from daily dysfunction of lower extremities due to fibula resection.Seven patients could eat normally with satisfactory facial appearance and clear voice postoperative communication.Trismus developed in 1 patient with radiation osteomyelitis.Conclusion Maxillofacial reconstructive operation with free fibula flap has favorable effects in repairing facial defects.Intensive preoperative preparation,postoperative observaion in flap situation and appropriate nurisng measures play an essential part in a successful operation.