环形鼻咽通气管在新生儿双侧先天性后鼻孔闭锁成形术的应用和护理  

The application and nursing of neonatal bilateral congenital choanal atresia plasty under the treatment of improved ring-shaped nasopharyngeal tube

作　　者：齐超[1] 邹宇[1] 陈月清[1] 彭文斌[1] Qi Chao;Zou Yu;Chen Yueqing;Peng Wenbin(Department of Otorhinolaryngology,Guangdong Women and Children Hospital,Guangzhou 511442,China)

机构地区：[1]广东省妇幼保健院耳鼻喉科,广州511442

出　　处：《国际医药卫生导报》2018年第15期2365-2368,共4页International Medicine and Health Guidance News

摘　　要：目的探讨环形改良鼻咽通气管在新生儿双侧先天．性后鼻孔闭锁（CCA）成形术的应用特点和护理要点。方法回顾分析2013年8月1日至2017年12月31日本院耳鼻喉科收治的18例新生儿双侧CCA患儿的临床资料，总结环形改良鼻咽通气管的应用特点与护理要点。结果本组病例中，l例患儿术后1个月拔管后出现狭窄，2例患儿术后5个月因扯断丝线造成鼻后缘受伤致疤痕狭窄（疤痕体质），此3例术后狭窄患儿均为骨性闭锁，行二次手术矫正；其余15例患儿术后3-6个月拔管痊愈，全组患儿无堵管发生。结论环形改良鼻咽通气管扩张治疗可以减少脱管，患儿佩戴无指手套可杜绝脱管发生，术后护理和出院指导对预防脱管、堵管尤为重要。Objective To discuss the application and nursing key points of neonatal bilateral congenital choanal atresia （CCA） plasty under the treatment of improved ring-shaped nasopharyngeal tube. Methods Retrospectively analyzed clinical data of 18 neonates with bilateral CCA in otorhinolaryngology department of our hospital from August 1, 2013 to December 31, 2017, summarized the application and nursing key points of improved ring-shaped nasopharyngeal tube. Results In this group, 1 case had choanal stenosis when pulling out the catheter 1 month after operation, posterior margin of the nose in 2 cases were wounded and leaded to cicatricial stenosis because of the silk thread broken 5 months after operation, all of them had bony atresia and underwent re-operated correcting. The other 15 children recovered well when pulling out the catheter within 3 to 6 months after operation. All children had no tube plugging. Conclusion The dilatation treatment of improved ring-shaped nasopharyngeal tube can avoid the catheter coming oft, which can be completely eradicated by wearing fingerless gloves, postoperative nursing and discharge guidance are the key points to prevent the catheter coming off and plugging.

关 键 词：先天性 新生儿 后鼻孔闭锁 鼻咽通气管 双侧 

分 类 号：R473.72[医药卫生—护理学]