摘要
目的探讨经鼻内镜鼻咽切除联合带血管蒂鼻腔粘骨膜瓣修复术治疗鼻咽坏死(post-radiation nasopharyngeal necrosis,PRNN)的围手术期护理要点,以便为护理该类疾病提供护理经验。方法2016年7月至2018年1月对本院收治的48例PRNN患者实施经鼻内镜鼻咽切除联合带血管蒂鼻腔粘骨膜瓣修复术,给予做好围手术期护理工作。结果48例PRNN患者均顺利完成手术,41例有头痛患者疼痛评分由术前中位数6.50分下降至术后0分,术后鼻臭消失,术前41例细菌培养阳性患者在围手术期无继发感染,无活动性出血、脑脊液漏等并发症。48例术后恢复良好,3~5d康复出院。结论对鼻内镜鼻咽切除联合带血管蒂粘骨膜瓣修复术患者,围术期应做好心理护理,营养支持,预防感染,术后预防出血,做好呼吸道护理,疼痛护理,预防呼吸道感染及脑脊液漏,出院指导等,其有助于促进患者康复,提高手术效果,对患者早日康复及改善患者的生存质量具有重要意义。
Objective To investigate the perioperative nursing points for patients undergoing post-radiation nasopharyngeal necrosis(PRNN)after endoscopic nasopharyngeal resection combined with vascular pedicled nasal mucoperiosteal repair.Methods From July 2016 to January 2018,48 patients with PRNN admitted to our hospital underwent endoscopic nasophaiyngectomy combined with vascular pedicle nasal mucosal flap repair,and perioperative nursing care was performed.Results All 48 patients with PRNN successfully lived through the operation.In 41 patients with headache,the pain score before operation was significantly decreased after operation(6.50 vs.0).The postoperative nasal odor disappeared.The bacterial cultures before operation were positive in 41 cases.There were neither secondary infections during the perioperative period,nor complications such as active bleeding or cerebrospinal fluid leakage.All the patients got recovered right or 3~5 days after operation.Conclusions The nursing measures including psychological care,nutritional support,infection prevention,postoperative bleeding prevention,respiratory care,pain care,prevention of respiratory tract infection and cerebrospinal fluid leakage,and discharge guidance during the perioperative period are conducive for the recovery of patients undergoing PRNN after endoscopic nasopharyngeal resection combined with vascular pedicled nasal mucoperiosteal repair.They are of great significance for their early recovery and improved quality of life.
作者
夏乐
萧燕华
胡雯
Xia Le;Xiao Yanhua;Hu Wen(Tumor Hospital,Sun Yat-sen University,Guangzhou,510060,China)
出处
《现代临床护理》
2019年第10期29-34,共6页
Modern Clinical Nursing
关键词
鼻咽坏死
鼻咽癌
鼻内镜
带血管蒂鼻腔粘骨膜瓣修复术
围手术期护理
nasopharyngeal necrosis
nasopharyngeal career
nasal endoscopy
vascular pedicle nasal mucosal flap repair
perioperative nursing
