陈建静　吴伯乐　刘青林　杜莹燕

[摘要] 目的 分析对自体游离硬腭黏膜移植联合眶周皮瓣修复全层眼睑缺损的护理措施及患者对护理的满意程度、护理后生活质量的改变。 方法 选取2012年1月～2014年1月间的180例行眼睑恶性肿瘤根治术后自体游离硬腭黏膜移植联合眶周皮瓣修复全层眼睑缺损的患者，采用随机数字表法将患者分为观察组和对照组各90例。对照组患者给予常规护理，观察组患者在常规护理措施基础上，给予对手术切口、口腔、心理的护理和饮食的管理对患者护理的满意程度和护理后的生活质量进行分析探究。 结果 两组患者护理后的SDS、SAS得分均显著降低，且观察组的降低幅度显著高于对照组，对照组患者总满意率54.4%，观察组患者总满意率94.4%，观察组患者护理后的生活质量各项评分均显著优于对照组，差异具有统计学意义（P<0.05）。 结论 结合常规护理，加强对患者手术切口、口腔、心理的护理和饮食的管理，能够缓解患者的焦虑、抑郁不良心理，有效预防感染和肿瘤的复发，提高患者的生活质量。

[关键词] 自体游离；硬腭黏膜；眶周皮瓣；全层眼睑；生活质量

[中图分类号] R473.77 [文献标识码] B [文章编号] 1673-9701（2015）35-0131-04

[Abstract] Objective To analyze autologous free palatal mucosa transplantation combined with full-thickness flap periorbital nursing and patient care after eyelid defects change the quality of life. Methods From January 2012 to January 2014， 180 routine eyelid malignant tumor free after autologous transplantation combined palatal mucosa flap periorbital defects in patients with full-thickness eyelid， using a random number table method were divided into observation group and control group with each 90 cases. Routine patient care administered to the control group， the observation group were given conventional care measures， based on the incision， oral care and dietary management psychology， as well as satisfaction with the quality of life of patients after nursing care and conduct analysis to explore. Results After treatment， SDS+SAS scores were significantly reduced between the two groups of patients， and a reduction in the observation group were significantly higher in patients in the control group of patients overall satisfaction rate of 54.4%. Overall satisfaction rate of the observation group were 94.4%， the quality of life of patients in the observation group care after the scores were significantly better than the control group patients were compared statistically meaningful difference between（P<0.05）. Conclusion The combination of routine care， enhance patient surgical incision， oral care and dietary management psychology， can relieve anxiety， depression adverse psychological， effective prevention of infection and tumor recurrence， improve the quality of life of patients.

[Key words] Autologous free； Palatal mucosa； Periorbital flap； Full-thickness eyelid； Quality of life

全层眼睑缺损的损害涉及眼睑的皮肤、全层睑板、周围的肌肉和全层结膜眼[1]。其中眼睑基底细胞癌是最常见的眼睑恶性肿瘤，约占恶性肿瘤的80%，表现为眼睑处有米粒大小的結节隆起[2]，结节周围可无新生血管，一般进展缓慢，病程较长，极少数患者发生远处转移。高保清等著名眼科专家首先在我国用硬腭黏膜移植术代替了睑板结膜重建眼睑术，为眼睑恶性肿瘤根治术后患者的眼睑重建提供了一种新的方法[3，4]。……