腹直肌皮瓣修复口腔颌面部软组织缺损的围术期护理

Perioperative nursing of rectus abdominis musculocutaneous flap in repairing oral and maxillofacial soft tissue defect

目的探讨腹直肌皮瓣移植修复口腔颌面部软组织缺损的围术期护理措施。方法对32例应用腹直肌皮瓣移植修复口腔颌面部软组织缺损患者进行优质护理，预防并发症的发生。结果本组32例移植皮瓣中28例全部成活、1例全部坏死、3例皮岛尖端小部分皮肤坏死（均不超过皮岛面积的10％）。14例半舌或部分舌缺损修复患者，舌外形恢复良好，其中2例言语功能差需辅助书面表达，余12例言语、咀嚼和吞咽功能恢复良好。17例颌面部缺损修复患者，面部外形恢复良好，张口度2．5～3．0cm，言语、咀嚼和吞咽功能恢复良好。结论细致、周到的护理对腹直肌皮瓣移植修复口腔颌面部软组织缺损具有重要的临床意义。

Objective To investigate perioperative nursing of rectus abdominis musculocutaneous flap in repairing oral and maxillofacial soft tissue defect. Methods High quality nursing was designed for 32 oral and maxillofacial soft tissue defects patients who received the transverse rectus ahdominis myocutaneous flap in repairing wounds to prevent the occurrence of complications. Results There were 28 patients with flaps transplantation alive, flaps in 1 patient with necrosis, flaps transplantation in 3 patients with 10 % or less necrosis at the edge of flaps. 14 patients with part or half of tongue reconstruction recovered well, among which 2 patients had weaker speech ability with writing expression to communicate. Meanwhile, speech expression, the chewing and swallowing function of the others 12 patients were recovered well. The recovery of facial appearance of 17 patients with maxillofacial defect repaired well, the mouth degree was 2.5 -- 3.0 cm, speech expression, chewing and swallowing function recovered well. Conclusion Careful nursing is of clinical importance in repairing oral and maxillofacial soft tissue defect with rectus abdominis musculocutaneous flap.