面部巨大神经纤维瘤术中大量出血合并术后气道阻塞的护理  

Nursing care of a patient with gigantic facial neurofibroma complicated by postoperative airway obstruction due to intraoperative massive blood loss

作　　者：李宇轩[1] 马宝府[1] 杨夏末[1] 柴秋香[1] 李秋月[1] 

机构地区：[1]北京大学第三医院危重医学科,北京市100191

出　　处：《中华护理杂志》2013年第1期34-35,共2页Chinese Journal of Nursing

摘　　要：报告了1例面部巨大神经纤维瘤患者瘤体切除时大量出血,合并术后头颈部组织严重肿胀,造成声门以上气道阻塞而导致气管插管拔除困难患者的护理经验。术前针对术中大出血的可能,完善血常规及凝血功能检查,充分准备。术后加强创面管理和出血的观察,做好口角、下颌、颈部皮肤护理,加强气管插管的护理,拔管前慎重评估,全面评估患者营养状况和自身条件后采取全胃肠外营养方式。患者创面愈合后,再次择期行面部整形术,于首次手术后第64天顺利出院。This article introduced the nursing care of a patient with facial gigantic neurofibroma complicated by postoperative airway obstruction and difficulty in extubation due to serious soft tissue edema in head and neck region caused by intraoperative massive blood loss. Before the operation,nursing care focused on preoperative preparations and routine blood test and coagulation function test. After the operation,the key points in nursing were intensive observation of hemorrhage and wound care,skin care around the mouth,lower jaw and neck,airway care and endotracheal tube care,careful assessment beiore extubation and nursing care of total parenteral nutrition. The patient received facial plastic surgery after the wound healing and was discharged from the hospital 64 days after the operation.

关 键 词：神经纤维瘤 出血 气道阻塞 护理 

分 类 号：R473.73[医药卫生—护理学]