19例婴幼儿微血管吻合术的围手术期护理

Peri-operative nursing care of 19 infants undergoing micro-vascular anastomosis

总结19例婴幼儿行微血管吻合术治疗复杂性外伤的围手术期护理,主要包括术前准备,患儿及家属的心理支持,术后评估局部组织血液循环,维持全身有效循环血量,镇痛、镇静、血管危象的护理等。本组11例患儿发生血管危象,护士均及时发现,经过积极治疗与护理,10例吻合血管存活,1例组织发生干性坏死;术中产生Ⅰ期与Ⅱ期压疮4例,均治愈,无新发压疮;总体疗效满意。

In this article,we summarized peri-operative nursing of 19 cases of infants who underwent micro- vascular anastomosis for the treatment of complex trauma. Peri-operative nursing included preoperative preparation, psychological supports for children and their families, and systematic, dynamic, accurate assessment of local tissue blood circulation after surgery, as well as maintaining effective circulating blood volume, medication care, analgesic, sedative, and nursing of vascular crisis. In this group, 11 cases developed vascular crisis which was discovered timely by nurses. After active treatment and nursing, lO eases of vascular anastomosis survived,and one case developed dry tissue necrosis. Four cases of stage Ⅰ and Ⅱ pressure ulcers occurred during surgery. All pressure ulcers were cured and no new case occurred; pain score ranged from 0 to 6 points,and the overall results were satisfactory.