皮肤软组织扩张与自体肋软骨移植外耳再造术的护理对策  

Nursing of auricular reconstruction using of skin tissue expanders method and autogenous costal cartilage framework

作　　者：李庆荣[1] 乔玉宁[2] 王可琼[1] 

机构地区：[1]中国人民解放军第105医院整形美容科,安徽合肥230031 [2]中国人民解放军第105医院护理部,安徽合肥230031

出　　处：《中国美容医学》2014年第1期70-72,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的：总结皮肤软组织扩张与自体肋软骨移植法外耳再造相关护理的经验及效果。方法：2008年1月至2012年1月共收治耳廓缺损患者20例，其中先天性小耳畸形18例，外伤性耳廓缺损2例；手术方法：I期耳后乳突区置入皮肤软组织扩张器，Ⅱ期利用扩张的耳后皮瓣及筋膜瓣覆盖自体肋软骨耳支架加皮片移植，形成再造耳，Ⅲ期行耳屏、耳甲腔等整形术。相应的护理对策措施主要有：围手术期的护理、心理护理、引流管的护理。结果：随访6个月～4年，均完成三期耳再造术，再造耳位置正常，形态良好，三维结构清晰，医患双方满意；未发生扩张器外露、感染、扩张器埋置术后血肿、软骨支架外露等并发症。结论：加强围手术期的护理和健康指导，可以减少并发症，是获得皮肤软组织扩张与自体肋软骨移植法外耳再造法手术成功的关键。Objective To improve the quality of auricular reconstruction using of skin tissue expanders method and autogenous costal cartilage framework. Methods From January 2008 to January 2012 twenty cases of auricle deformities were performed by our method of ear reconstruction. Eighteen cases were microtia. Other two cases were aquired defects from injury. Auricular reconstruction was performed in three surgical stages. In the first stage, a 50 ml kidney-shaped expander was inserted subcutaneously in the retroauricular mastoid region. In the second stage, autogenous costal cartilage framework was enveloped by the expanded flaps. Tragus construction and conchal excavation was performed in the third stage. Results All patiehts were followed up from six months to four years. A total of 20 cases reported to be satisfied with the appearance of good shape, accurate size and duplication of well-detailed structures. Both the patients and the surgeons were satisfactory. Hematoma, expander exposure, cartilage framework exposure were not occurred in our cases. Conclusion Good preoperative and postoperative nursing care is a prerequisite for the improvement of the therapeutic efficacy of auricular reconstruction using kin tissue expanders method and autogenous costal cartilage framework.

关 键 词：护理 耳再造 耳软骨支架 组织扩张 

分 类 号：R471[医药卫生—护理学]