唇裂术后鼻畸形矫正术后的观察与护理

Cleft lip nasal deformity postoperative observation and care

目的：探讨鼻部亚单位综合整形矫正单侧完全性唇裂鼻畸形术后的临床观察与护理.方法：2007年1月至2011年6月收治79例单侧完全性唇裂修复术后鼻畸形病例.该组病例男35例,女44例;年龄9～53岁.左侧4 3例,右侧36例.唇裂修复术至二期矫正手术间隔时间为2～52年,平均15年.鼻畸形主要为鼻小柱向健侧偏斜、短缩,鼻中隔歪曲,鼻翼扁平、塌陷,鼻孔宽大、双侧不对称,鼻翼脚错位,口鼻漏等,根据患者不同的畸形情况制定不同的综合鼻整形方案,并个性化进行术前、术中、术后护理干预.结果：患侧鼻翼基本恢复正常弧度,双侧鼻孔对称.术后患者均获随访,随访时间3个月～2年,平均1 0个月.切口隐蔽,未见明显瘢痕,鼻外形维持良好.结论：根据鼻部各亚单位畸形特点及形成原因,进行个性化设计及矫正,再配合正确的护理干预,使得临床效果十分满意.

Objective To explore the nursing strategy after nasal subunit comprehensive orthopedic complete unilateral cleft lip nasal deformity surgery to promote clinical outcome.Methods From January 2007 to June 2011,79 patients with nasal deformity after prothesis of unilateral complete cleft lip were treated.There were 35 males and 44 females aged 9～53 years old.The deformity located on the left side in 43 cases and the right side in 36 cases.Time between cleft lip prothesis and secondary epithesis was 2～52 years （average 15 years）.The major manifestations of the deformity were deviation and crispation towards normal side of nasal columella,distortion of nasal septum,applanation and collapse of nasal ala,lenity and asymmetry of nostrils,malposition of nasal alar basement.Patients with abnormal situations according to the different integrated rhinoplasty for different programs and personalized preoperative,intraoperative and postoperative care intervention.Results The effect of epithesis was good with such manifestations as the normal radian of injured nasal ala and symmetrical nostils.All patients were followed up for 3 months～2 years （average 10 months）.The incision was hidden with well-maintained appearance and no obvious scar.Conclusion Based on feature of nasal subunits and formation causes of deformity,the individual-orientated epithesis design and correction were performed.Together with the right care intervention,satisfactory clinical results were obtained.