目的探讨和总结血管化自体颌下腺移植术中重建血液循环的护理配合措施。方法分析2005年1月—2009年3月北京大学口腔医院手术室完成的56例血管化自体颌下腺移植手术的临床资料,总结术中血液循环重建时的护理配合体会。结果 56例自体颌下腺移植手术结束时,移植腺体的血液循环全部重建满意,吻合口血流通畅,没有血栓形成。术后48 h内出现血管危象7例,腺体抢救成活6例,移植成功率98.21%。结论自体颌下腺移植治疗角结膜干燥症手术成功的关键是重建血液循环,术中护理的重点是预防血管危象,主要措施包括罂粟碱持续湿敷、温盐水热敷以及对并发症患者进行特别护理等,实践证明取得良好效果。
Objective To summarize the cooperative measures on circulation restore during the operation of micro-vascular submandibular gland transfer.Methods Fifty-six cases of microvascular submandibular gland transfer were performed in Peking University School Hospital of Stomatology from January 2005 to March 2009.The related data was collected retrospectively and the cooperative measures on circulation restore during the operation were summarized.Results The circulation restore of transferred glands were satisfied in all 56 cases when the submandibular gland transfer operation finished.Thrombosis happened in 7 cases within the postoperative 48 hours and the secondary emer-gency operations were done.At last 6 glands were salvaged and the final successful rate was 98.21%.Conclusion Successful circulation restore was one of the key points on microvascular submandibular gland transfer.The most important mission of the nursing during the operation was the prevention of vascular crisis.The main measures include persistent wet packing using narceine,fomentation using warm saline and special nursing on postoperative complications.Our experience proves that it is beneficial to the success of operation.