Nagata术式行全耳再造术后并发症的护理方案

Nursing Plan of Complications after Ear Reconstruction Using Nagata Technique

目的探讨采用Nagata术式行小耳畸形耳再造的术后并发症的护理方法。方法回顾本中心采用Nagata术式自体肋软骨移植进行耳郭再造的患者,针对术后出现的血肿、皮瓣缺血坏死、感染、支架外露等并发症情况,运用序贯护理和外科换药相结合的干预方法进行针对性处理,观察术后并发症的预后情况。结果468例患者中,术后出现并发症患者共18例,其中血肿10例、皮瓣坏死2例、感染5例、支架外露1例,通过序贯护理和专科换药,均达到伤口愈合(III类乙级),避免了再次手术。术后随访半年,再造耳形态良好。结论对于采用Nagata术式行全耳再造的术后并发症,针对性的宣教、外科换药及序贯护理方案,可显著减少术后并发症的恢复时间,避免再次手术,值得临床推广应用。

Objective To explore the nursing measures for complications after ear reconstruction using Nagata technique in microtia patients.Methods Microtia patients undergoing ear reconstruction using autogenous rib cartilage with Nagata technique were retrospectively analyzed.In view of postoperative complications such as hematoma,skin flap necrosis,infection and stent exposure,sequential nursing and surgical dressing change were combined for targeted treatment,and the prognosis of postoperative complications was observed.Results A total of 468 cases were retrospectively reviewed.Among all the cases,18 patients had postoperative complications,including 10 cases of hematoma,2 cases of skin flap necrosis,5 cases of infection and 1 case of stent exposure.All of the reconstructed ears achieved wound healing(Class III,b)after careful sequential nursing and dressing change,and reoperation was avoided.The patients were followed up for half a year and the reconstructed ear was in good shape.Conclusion For postoperative complications of total ear reconstruction using Nagata technique,targeted education,dressing change and sequential nursing can significantly reduce the recovery time of postoperative complications and avoid reoperation,which is worthy of clinical promotion and application.