In the general nursing of cleft lip and palate, the ward after cleft lip and palate surgery should pay attention to keep warm to prevent colds. In addition to injecting antibiotics to prevent infection, lip wounds should be cleaned with hydrogen peroxide and normal saline 2-3 times a day, and nitrofurazone solution, ephedrine solution or chloramphenicol solution can be dripped into nasal cavity 3-4 times a day to reduce nasal secretions, keep the wound clean and dry, and prevent the wound from erosion. Don't let children cry loudly. Children with cleft lip can be fixed with lip arch. Parents should prevent their children from touching or hitting the wound or stuffing their fingers or toys into their mouths, and avoid drinking water through straws to prevent the wound from cracking.
Cleft lip and palate wounds should always be kept clean. Wipe the lip wounds with physiological saline and 75% alcohol cotton swab after each feeding or eating, and the movements should be gentle. It usually takes 5 days to remove stitches. After cleft lip and palate surgery, children should be taught to rinse their mouths with light salt water or D'Aubert solution to keep their mouths clean.
Patients with cleft lip and palate should closely observe the bleeding after operation. If there is a lot of bleeding, it should be treated immediately, and if necessary, inform the doctor to suture again.
Patients with cleft lip and palate under general anesthesia were given routine care after general anesthesia, and the pillow was removed and the head was tilted to one side. Closely observe the changes of vital signs, keep the respiratory tract unobstructed, give oxygen, and suck out oral secretions in time to prevent vomit or blood from flowing into the trachea to cause suffocation or aspiration pneumonia. When the child cries hoarsely, symptomatic treatment (such as atomizing inhalation) can be given to relieve laryngeal edema caused by general anesthesia intubation; If the child snores or loses his tongue, he should deal with it immediately.
Nursing diet for cleft lip and palate, a small amount of glucose water can be given to children with cleft lip and palate after 6 ~ 8 hours of awake after operation. If you don't vomit, you can start breastfeeding with a dropper or spoon. If the child refuses to eat because of the pain in the wound, he can properly replenish fluids to maintain the balance of water and electrolyte. Adult patients take liquid diet 1 week, and then gradually change from semi-liquid to soft food; Patients with cleft palate were given liquid diet for 2 ~ 3 weeks after operation, then changed to semi-liquid diet 1 week, and then gradually changed to soft food, and insisted on feeding with a spoon. After each meal, use mouthwash to clean up the food residue in the mouth, keep the mouth clean and carry out pronunciation training.
Nursing care of cleft lip and palate wound: if the wound heals well, the suture should be removed 5 ~ 7 days after cleft lip operation, and if lip arch is used, the suture should be removed at least 10 day after operation; After cleft lip and palate surgery, the iodine spinning strips in the oral cavity can be taken out in 7 ~ 12 days. If there is no bleeding, it can't be stuffed again. The cleft lip and palate can be removed two weeks after cleft lip and palate surgery. Go home after one day's observation, and pay special attention to diet.
Before the operation, we should strengthen nutrition, enhance resistance and avoid catching a cold. Clean your mouth a few days before cleft lip and palate surgery to prevent postoperative infection.
Cleft lip and palate should be fed liquid food and semi-liquid food (such as milk, juice, noodles, custard, etc.). ) During hospitalization, there were soft food, noodles, soft rice and porridge. It should be taken within two months after discharge to avoid dry and hard food with residue, so as not to stimulate the wound and affect healing or re-cracking.
For children with cleft lip and palate, parents should teach them to practice pronunciation as soon as possible after cleft lip and palate surgery.
Psychological care of cleft lip and palate Because cleft lip and palate is a congenital defect, most patients have inferiority complex, which often leads to a sense of loss and loneliness. Most of them come from poor mountainous areas, and their cultural quality is low, which leads to anxiety and fear. Cleft lip and palate nurses apply nursing procedures to solve patients' psychological problems, and take corresponding nursing measures in time: (1) Establish a good nurse-patient relationship, and influence patients' feelings and understanding through patients' good words, expressions, attitudes and behaviors in the process of communication with patients, so as to change patients' psychological state; (2) Do a good job of family members and provide psychological support; (3) Psychological counseling should be given to all kinds of psychological problems after cleft lip and palate surgery, so as to increase patients' confidence and sense of security in rehabilitation, help them establish the best psychological state conducive to treatment and rehabilitation, make them actively cooperate with treatment and nursing, and recover and leave the hospital as soon as possible.