保留和不保留扁桃体的茎突切除术后的护理观察

Nursing observation after styloidectomy with and without tonsillectomy

目的探讨对经口的保留和不保留扁桃体的茎突切除术后的护理观察。方法选取经口的茎突切除术26例,其中切除扁桃体的茎突切除术11例,保留扁桃体的茎突切除术15例,对不同术式的术后咽部疼痛、术后出血、切口愈合三个项目进行观察。结果经过术后护理观察,术后咽部疼痛的评分切除扁桃体组明显高于保留扁桃体组;术后出血发生率为切除扁桃体组为3/11、保留扁桃体组为0/15;切口愈合切除扁桃体组在1周扁桃体切除后创面假膜脱落者为0/11,2周假膜脱落者6/11,3周假膜脱落者5/11;保留扁桃体组1周切口缝线脱落者2/15,2周切口缝线脱落者6/15,3周切口缝线脱落者7/15。1例因为上方切口裂开扁桃体下垂致凹陷愈合。结论经过术后护理观察对比,经口的保留扁桃体的茎突切除术术后反应明显轻于切除扁桃体的茎突切除组,值得临床推广。

Objective To research the nursing observation after styloidectomy with and without tonsil reservation.Methods 26 cases of styloidectomy were selected,including 11 cases with tonsillectomy and 15 cases without tonsillectomy.Three items of postoperative pharyngeal pain,postoperative bleeding and incision healing were observed.Results According to postoperative nursing observation,the score of pharyngeal pain in the tonsillectomy group was significantly higher than that in the tonsil reservation group.The incidence of postoperative bleeding was 3/11 in the tonsillectomy group and 0/15 in the tonsil reservation group.As far as incision healing,in the tonsillectomy group the incidence of wound pseudomembrane abscission was 0/11 one week after operation,6/11 two weeks after operation and 5/11 three weeks after operation.Whilist in the tonsil reservation group the rate of suture falling off 2/15 one week after operation,6/15 two weeks after operation and 7/15 three weeks after operation.One case appeared concavity healing due to tonsilloptosis caused by upper incision rupture.Conclusions According to comparison in the postoperative nursing observation,the postoperative responses of styloidectomy with tonsil reservation is significantly lighter than that of styloidectomy with tonsillectomy.