摘要
报告了34例口腔颌面部组织瓣修复术后患者发生血管危象的原因分析及护理对策。分析主要原因为:吻合动脉痉挛血管栓塞;组织肿胀导致皮岛穿支於堵、受压,皮瓣供血受阻;放疗后受区血管条件欠佳;术区积液长期浸润,外部刺激致血管破裂;凝血功能差,局部渗血多,压迫血管蒂等。本组完善术前个体化评估准备;术后密切的生命体征监测、个体化皮瓣观察、有效体位、营养支持、预防感染、避免出血,加强心理护理,保持患者情绪稳定,可降低血管危象的发生,提高皮瓣成活率。
The causes and nursing strategies of vascular crisis in 34 patients with oral and maxillofacial flap repair were reported.The main reasons are as follows:anastomotic artery spasm and vascular embolism;tissue swelling causes the perforator of skin island to be blocked and compressed,and the blood supply of flap is blocked;the vascular conditions in the receiving area are not good after radiotherapy;the long-term infiltration of fluid in the operation area,external stimulation causes the rupture of blood vessels;poor coagulation function,more local blood leakage,compression of vascular pedicle,etc.After operation,close monitoring of vital signs,individualized flap observation,effective posture,nutritional support,prevention of infection,prevention of bleeding,strengthening of psychological care,maintaining emotional stability of patients can reduce the occurrence of vascular crisis and improve the survival rate of flap.
作者
刘秋玲
张丽萍
吴娟
黄敏红
刘金娟
方玲
LIU Qiu-ling;ZHANG Li-ping;WU Juan;HUANG Min-hong;LIU Jin-juan;FANG Ling(Department of Stomatology,Sun Yat Sen Memorial Hospital of Sun Yat sen University,510120,Guangzhou,GuangDong)
关键词
口腔颌面部
组织瓣
血管危象
观察
护理
oral and maxillofacial
tissue flap
vascular crisis
observation
nursing
