头颅外置强支抗骨缝牵张术在治疗儿童面中部凹陷畸形中的护理关键环节  

Key Aspects of Nursing Care in Skull External Fixation Distraction Osteogenesis Treatment of Midfacial Depression Deformity in the Children

作　　者：权会利 李茹 权佳乐 姬晴 张文慧 刘富伟 封兴华 张浚睿 QUAN Huili;LI Ru;QUAN Jiale;JI Qing;ZHANG Wenhui;LIU Fuwei;FENG Xinghua;ZHANG Junrui(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Oral and Maxillofacial Surgery,the Third Hospital Affiliated of Air Force Military Medical University,Xi'an 710032,Shaanxi,China;Xianyang Hospital of Yan'an University Stomatological Hospital,Xianyang 712099,Shaanxi,China)

机构地区：[1]口颌系统重建与再生全国重点实验室、国家口腔疾病临床医学研究中心、陕西省口腔疾病临床医学研究中心、空军军医大学第三附属口腔医院口腔颌面外科,陕西西安710032 [2]延安大学咸阳医院口腔病院,陕西咸阳712099

出　　处：《中国美容医学》2024年第12期76-80,共5页Chinese Journal of Aesthetic Medicine

基　　金：陕西省重点研发计划项目(编号:2023-YBSF-433)。

摘　　要：目的:明确头颅外置强支抗骨缝牵张术在治疗儿童面中部凹陷畸形中的护理关键环节,并给予针对性护理方案。方法:选取2021年3月-2023年3月笔者医院行头颅外置强支抗骨缝牵张术的58例面中部凹陷畸形患儿,按随机数字表法分为对照组和实验组各29例,对照组给予常规护理,实验组在常规护理基础上,分析围手术期护理关键环节,给予针对性护理方案,评估两组护理效果。结果:实验组患儿及家长焦虑评分均明显低于对照组(P<0.05);对照组头部钉周伤口感染176个(60.69%)、鼻部牵引钩处伤口感染20个(34.48%),实验组头部钉周伤口感染3个(1.03%)、鼻部牵引钩处伤口感染2个(3.45%),实验组患儿头部牵引钉周伤口感染率和鼻部牵引钩处伤口感染率均明显低于对照组(P<0.05);实验组患儿疼痛评分低于对照组,睡眠及护理满意度评分均高于对照组,差异均有统计学意义(P<0.05)。结论:头架体积大、组织穿通固定点多以及需长期佩戴是影响该类患儿护理的核心,应使患儿形成正确的佩戴习惯,并严密控制感染等问题,以最大程度减少对患儿生活的影响。Objective To clarify the key links of nursing care in skull external fixation distraction osteogenesis treatment of midfacial depression deformity in the children,and to give targeted nursing program.Methods A total of 58 children with midfacial depression deformity who had undergone skull external fixation distraction osteogenesis in the author's hospital were selected from March 2021 to March 2023,and were randomly divided into 29 cases each in the control group and the experimental group to assess the nursing effect of the two groups.The control group was given routine nursing care.The experimental group was analyzed the key links of perioperative nursing care on the basis of routine nursing care,and was given targeted nursing care program.Results The anxiety scores of children and their parents in the experimental group were significantly lower than those in the control group(P<0.05).In the control group,176(60.69%)and 20(34.48%)of the head nail and nasal traction hook wounds were infected,while 3(1.03%)and 2(3.45%)of the head nail and nasal traction hook wounds were infected in the experimental group.The wound infection rate around the head traction nail and the wound infection rate at the nasal traction hook in the experimental group were significantly lower than those in the control group(P<0.05).The pain score of the experimental group was lower than that of the control group,and the sleep and nursing satisfaction scores were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The large size of the head frame,the large number of fixation points for tissue penetration and the need for long-term wear are the core factors affecting the care of this type of children.Children should be made to form correct wearing habits and problems such as infection should be closely controlled to minimize the impact on their lives.

关 键 词：头颅外置强支抗 骨缝牵张 面中部凹陷畸形 儿童 护理 关键环节 

分 类 号：R473[医药卫生—护理学]