先天性小耳畸形术后皮瓣破裂或坏死的危险因素及护理对策  

Risk factors and nursing strategies of flap rupture or necrosis after operation of congenital microtia

作　　者：刘怡伶[1] LIU Yi-ling(Department of Plastic Otolaryngology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第二附属医院整形耳鼻喉科,河南郑州450000

出　　处：《青岛医药卫生》2021年第5期392-394,共3页Qingdao Medical Journal

摘　　要：目的探讨先天性小耳畸形术后皮瓣破裂或坏死的危险因素及护理对策。方法选择2016年5月至2020年5月于本院行先天性小耳畸形术的患者231例作为研究对象,根据术后是否发生皮瓣破裂或坏死分为发生组(n=26)与未发生组(n=205),分析影响患者术后发生皮瓣破裂或坏死的相关因素。结果单因素分析结果显示,发生组与未发生组性别、BMI、先天性小耳畸形部位、耳廓再造方法、手术时间比较差异无统计学意义(P>0.05),年龄、合并慢性疾病、耳廓畸形Max分型、外耳道闭锁分级及术中出血量比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、合并慢性疾病、耳廓畸形Max分型、外耳道闭锁分级以及术中出血量是先天性小耳畸形术后发生皮瓣破裂或坏死的独立危险因素(OR=1.967、2.328、2.789、1.205、1.990,P<0.05)。结论先天性小耳畸形术后皮瓣破裂或坏死与年龄、合并慢性疾病、耳廓畸形Max分型、外耳道闭锁分级以及术中出血量等多种因素密切相关,临床上应严格把握手术要点,针对性地予以护理措施,以此减少术后皮瓣破裂或坏死等发生情况。Objective To investigate the risk factors and nursing strategies of flap rupture or necrosis after operation of congenital microtia.Methods A total of 231 patients with congenital microtia treated in our hospital from May 2016 to May 2020 were selected and divided into occurrence group(n=26)and the non-occurrence group(n=205)according to the occurrence of flap rupture or necrosis.Results Univariate analysis showed that there were no differences in gender,BMI,location of congenital microtia,method of auricular reconstruction and operation time between the two groups(P>0.05),but there were differences in age,chronic diseases,Max classification of vestibule malformation,classification of atresia of external auditory canal and intraoperative blood loss(P<0.05).Multivariate logistic regression analysis showed that age,chronic diseases,Max classification of auricular malformation,classification of atresia of external auditory canal and intraoperative blood loss were independent risk factors for flap rupture or necrosis after operation(OR=1.967,2.328,2.789,1.205,1.990,P<0.05).Conclusion The rupture or necrosis of skin flap after operation of congenital microtia is closely related to many factors,such as age,chronic diseases,Max classification of auricular malformation,classification of atresia of external auditory canal,and intraoperative blood loss,etc.In clinic,we should strictly grasp the key points of operation and take targeted nursing measures to reduce the occurrence of postoperative flap rupture or necrosis.

关 键 词：先天性小耳畸形 皮瓣破裂或坏死 危险因素 护理对策 

分 类 号：R473.72[医药卫生—护理学]