儿童经口手术的围手术期处理  

Perioperative management for pediatric transoral surgery

作　　者：王建华[1] 夏虹[1] 尹庆水[1] 马向阳[1] 艾福志[1] 戴建强[1] 邓小玲[1] 

机构地区：[1]广州军区广州总医院骨科医院,510010

出　　处：《中国骨科临床与基础研究杂志》2013年第3期143-147,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广东省科技计划项目(20120318084)

摘　　要：目的：探讨儿童经口手术的围手术期处理方法，降低术后并发症发生率。方法对2007年3月至2012年12月广州军区广州总医院骨科医院手术治疗的18例儿童上颈椎疾患进行围手术期处理，观察患儿术后脊髓功能恢复和压迫改善情况，以及咽喉部切口愈合情况。结果日本骨科学会（JOA）评分由术前的（9.1±1.5）分改善为术后的（14.5±2.1）分，脑干延髓角（CMA）由术前的（135±14）°改善为术后的（156±10）°，差异均有统计学意义（P＜0.05）。无一例出现伤口感染，切口于8～10 d内愈合。结论采取周密的术前检查和评估，实施严格的围术期口腔护理，加强术后气道管理和早期营养支持，可有效降低儿童经口手术术后并发症的发生风险，保障手术安全实施，提高手术治疗效果。Objective To explore perioperative management for transoral surgery in children, and to reduce the incidence of postoperative complications. Methods From March 2007 to December 2012, 18 children with upper cervical diseases underwent transoral surgery and were received perioperative management in Guangzhou General Hospital of Guangzhou Military Command. Postoperative spinal cord functional restoration, decompression and pharyngolaryngeal wound healing were observed. Results Japanese Orthopaedic Association （JOA） scores and cervicomedullary angle （CMA） were improved from preoperative （9.1 ± 1.5）, （135 ± 14）° to postoperative （14.5 ± 2.1） and （156 ± 10）° respectively, the differences had statistical significance （P 〈0.05）. No incision infection had happened, and wound healing was obtained in 8-10 d in all children. Conclusion Perioperative management including thorough preoperative examinations and evaluations, strict perioperative mouth care, intensive postoperative airway management and early nutrition support, could reduce incidence of postoperative complications effectively for pediatric transoral surgery, ensure safty of surgery and improve clinical effects.

关 键 词：颈椎 经口手术 围手术期 手术后并发症 儿童 

分 类 号：R726.5[医药卫生—儿科]