1例双侧颞下颌关节强直患者伴张口受限30年的护理体会

A Case of Bilateral Temporomandibular Joint Ankylosis with Restricted Mouth Opening for 30 years

总结双侧颞下颌关节强直患者的护理经验体会。选取2021年11月南京医科大学附属口腔医院收治的1例双侧颞下颌关节强直患者作为研究对象,该患者因双侧颞下颌关节强直收入院,既往有右侧关节骨折病史。入院后在全麻下行“导航下右侧颞下颌关节成形术+右侧颞肌筋膜瓣转移术+肌筋膜悬吊术+面神经松解解压术+颞下颌关节病骨关节刨削术+右侧颞下颌关节盘手术+深部肿物切除术+双侧下颌骨C型截骨术+颌间结扎术”,术后予以抗炎补液等治疗。本病例患者有营养不良、张口受限等健康问题,患者体质量指数值为16.77 kg/m^(2),体重偏低,可能会出现营养不良、免疫力下降等情况。在过去的30年中,患者有张口有限的情况,张口度为0 cm。患者入院后接受营养专家和康复锻炼组的特殊指导和治疗。

The experience of caring for patients with bilateral temporomandibular joint ankylosis is summarized.A patient with bilateral temporomandibular joint ankylosis admitted to the hospital in November 2021,who was admitted for bilateral temporomandibular joint ankylosis and had a previous history of right-sided joint fracture,was selected as the study subject.After admission,the patient underwent“right temporomandibular arthroplasty+right temporal myofascial flap transfer+myofascial suspension+facial nerve release and decompression+osteoarthroplasty for temporomandibular joint disease+right temporomandibular joint disk surgery+deep mass excision+bilateral mandibular C-shaped osteotomy+intermaxillary ligation”under general anesthesia,and was treated with postoperative anti-inflammatory and rehydration therapy.The patient had health problems such as malnutrition,restricted mouth opening,and a BMI of 16.77 kg/m^(2),which was low weight and may lead to malnutrition and decreased immunity.During the last 30 years,the patient had limited mouth opening with 0 cm.The patient was admitted to the hospital and received special instruction and treatment from a nutritional specialist and a rehabilitation exercise group.