骶骨肿瘤切除术的围术期护理体会  

Perioperative Nursing Experience of Sacral Tumor Resection

作　　者：王微微[1] 韦梅[2] 陈珍珍[1] 刘立娟[1] 流小舟[1] 楼燕凤[1] 

机构地区：[1]南京军区南京总医院骨科,南京210002 [2]南京军区南京总医院急诊科

出　　处：《解放军护理杂志》2011年第14期38-41,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨骶骨肿瘤切除术患者的围术期护理措施。方法回顾性总结2008年1月至2010年12月实施骶骨肿瘤切除术的37例骶骨肿瘤患者的临床资料及围术期护理措施。结果术后随访4~36个月,所有患者术后疼痛基本消失或遗有轻微疼痛。有2例出现了排尿困难;1例出现大小便均困难,经过神经营养治疗后均得到改善;3例因皮瓣坏死发生伤口延迟愈合;2例出现下肢麻木;2例脊索瘤患者中1例于术后2年复发、1例于3年后复发;1例平滑肌肉瘤患者于1年后复发。结论术前进行有针对性的心理疏导、彻底的胃肠道准备和会阴括约肌的收缩与扩张训练,术后严密观察生命体征及神经功能变化、做好体位和疼痛的护理、加强肢体康复锻炼指导、预防并发症等围术期护理措施,是保证手术治疗效果的关键环节。Objective To discuss the perioperative nursing measures of primary sacral tumor resection.Methods From 1 January 2008 to December 2010,the clinical data and perioperative nursing measures of 37 cases of primary sacral tumor resections were summarized retrospectively.Results The postoperative pains disappeared basically or left slightly in all the patients with 4-36 months of follow-up.Of all the patients,two were observed with dysuria,one with difficulty in defection,which were improved after neurotrophic treatment,three with delayed union following skin flap necrosis,two with numbness of low limbs,of the two patients with chordoma,one relapsed one year after surgery and another relapsed three years after surgery.Leiomyosarcoma relapsed in one patient one year after surgery.Conclusion The keys to successful surgery lie in the perioperative nursing measures of preoperative targeted psychological counseling,complete gastrointestinal preparation and perineal sphincter contraction and expansion training,postoperative close observation of vital signs and neurological changes,good posture and pain nursing,physical rehabilitation exercises to strengthen the guidance,prevention of complications.

关 键 词：骶骨肿瘤 切除术 围术期 护理 

分 类 号：R473.6[医药卫生—护理学]