脱细胞牛心包生物补片联合假体乳房再造术的护理

The nursing care for patients receiving acellular bovine pericardium with implant based breast reconstruction

目的总结乳腺癌行脱细胞牛心包生物补片联合假体即刻乳房再造手术的护理经验。方法对2017年2月至2019年3月开展的100例临床资料进行回顾性分析,总结相关护理经验:术前使用决策辅助工具降低患者决策困境;正确评估患者高危因素与美学需求;术中预防使用抗生素遵循无接触原则;术后再造乳房的塑形、并发症的观察护理以及详细的出院计划和术后随访是护理的要点。结果1例发生部分皮肤坏死行假体取出术,1例出现乳头坏死行邻近皮瓣转移术,1例患者出现"红乳房"综合征,2例出现感染。出院后对本组病例进行随访,其中乳房满意度的得分为96.63分(百分制),患者对医护团队满意度得分为98.78分。结论精心细致的围手术期护理,可减少相关并发症的发生率,使患者正确预知手术结局,提高补片联合假体植入手术的成功率。

Objective This article explored the experience of nursing care for patients receiving acellular bovine pericardium with implant based breast reconstruction.Methods A total of 100 cases from February 2017 to March 2019 were retrospectively analyzed.Preoperative use AIDS decision-making to reduce the decision-conflict of patients,and correctly assess the risk factors and aesthetic needs of patients,to assist the selection of appropriate prosthesis.Intraoperative use of antibiotics immersion prosthesis and mesh to prevent infection,and follow the principle of no contact;Postoperative attention should be paid to breast reconstruction,skin observation and catheter care,to avoid infection,skin necrosis and seroma and other complications.And for patients to develop a detailed discharge plan,do a good job of continuing care.Results Of the 100 patients in this group,local skin necrosis occured in 1 patient,1 had nipple necrosis,1 had"red breast"syndrome and 2 had infection.All 100 patients successfully completed the surgery,with high satisfaction for breast reconstruction.The follow-up time ranged from 3 to 21 months,among which the score of breast satisfaction was 96.63(on a 100-point scale),and the score of patients′satisfaction with the medical team was 98.78.Conclusions Careful perioperative nursing can reduce the incidence of related complications,make patients correctly predict the outcome of surgery,and improve the success rate of mesh and prosthesis implantation.