颈部淋巴结清扫术后并发乳糜漏患者的护理  

Nursing of Patients with Chylous Fistula after Neck Dissection

作　　者：张红英[1] 刘青青[1] 肖敏[1] 何华英[1] 吴高松[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院综合医疗科,湖北武汉430030

出　　处：《护理学报》2010年第7期55-56,共2页Journal of Nursing（China）

基　　金：湖北省自然科学基金(2008CDB179)

摘　　要：总结1992年6月—2008年6月收治的39例颈部淋巴结清扫术后并发乳糜漏患者的护理。术后将患者安置于监护室,严密监测患者的生命体征变化,以防患者在麻醉清醒过程中因躁动不安致结扎线脱落或结扎线近端胸导管破裂致乳糜漏;颈部淋巴结清扫术后早期引流液常因禁食、渗血而不典型,一般为淡血性,当出现乳白色或浑浊引流液即可诊断为乳糜漏。定时观察引流液的变化,如引流量增多、呈乳白色或透亮的淡黄色,配合处理;定时检查引流管有无堵塞、打折,保持有效负压,调节吸引负压为-50～-80kPa;控制饮食,改为低脂饮食或禁食;观察药物的疗效和不良反应;做好心理护理。通过精心治疗和护理,本组患者均痊愈,愈合时间3～12d,平均7d。无再手术患者,未发生切口积液、感染等并发症。随访4个月至11年无复发病例。The paper summarizes the experience in nursing 39 patients with chylous fistula after neck dissection during June 1992 to June 2008.The nursing strategy includes close monitoring of vital signs in case of chylous fistula caused by amotio of ligature and rupture of thoracic duct because of restlessness of patients,timely and correct confirmation of chylous fistula if the drainage flew out milky white,regular observation of drainage,regular check if the tube is stuffed or bent,keeping effective negative pressure to-50～80 kPa,dieting with low fat or even fasting,observation of the adverse reaction of drugs and conducting of mental nursing.By tender care,all the 39 patients were healed,with healing duration of 3～12 days,averaged 7 days.None underwent second operation and no wound fluids and infections happened.The follow-up of 4 months to 11 years found no relapse.

关 键 词：手术后并发症 乳糜瘘 护理 

分 类 号：R473.6[医药卫生—护理学]