牙根误入上颌窦行冲洗取出术的围手术期护理

Perioperative nursing care for removal of broken teeth roots from maxillary sinus

对一例在外院口腔颌面外科行右上第一磨牙残冠拔除术时误将腭侧牙根推入上颌窦中的患者,术前常规拍摄正位及侧位X线片以建立三维空间模型,辅助拍摄术前锥形束CT(cone beam computed tomography,CBCT),证实断根位于上颌窦内后,医生行冲洗取出术并进行上颌窦瘘口修补术。护士在术前做好心理护理、手术器械准备及患者准备;术中与医生密切配合;术后做好伤口护理,饮食护理,口腔护理,健康教育等,预防上颌窦炎等并发症的出现,有助于促进创口愈合。术后随访虽可见患处有不同程度肿胀,但无口腔上颌窦瘘及感染发生,拔牙创口I期愈合。借此笔者提出对此类患者需要做好围手术期相关护理,通过术前护理人员缜密准备、术中医护密切配合和术后有效康复指导,为手术的顺利进行和良好预后奠定基础。

For a patient whose palatal root of the upper first molar was mistakenly pushed into the maxillary sinus during molar extraction in a local hospital,we first took anteroposterior and lateral X-ray films to establish a three-dimensional spatial model,assisted with the preoperative CBCT,which confirmed that the residual root is in the maxillary sinus,then we rinsed it out,and the doctor repaired the maxillary sinus fistula.During this process,nurses did preoperative psychological care,surgical instrument preparation and patient preparation,cooperation with the doctor during surgery,postoperative wound care,dietary care,oral care,health education,etc,to prevent complications such as maxillary sinusitis,to promote wound healing.We detected little swelling in postoperative follow-up,with no oral maxillary sinus fistula and infection,the wound achieved phase I healing.Thereby,we proposed that such patients need such a perioperative-related care,which including preoperative nursing preparation,surgical cooperation and effective postoperative rehabilitation guidance,to lay the foundation for the surgery operation and good prognosis.