颅颌面巨大肿瘤联合切除术的围手术期护理  

Perioperative nursing of craniofacial resection for patients with bulky craniomaxillofacial tumors

作　　者：黄秋雨[1] 古文珍[1] 林丽婷[1] 苏宇雄[1] 何杏芳[1] 廖贵清[1] 

机构地区：[1]中山大学光华口腔医学院·附属口腔医院,广东省口腔医学重点实验室,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2013年第2期48-51,共4页Chinese Journal of Stomatological Research(Electronic Edition)

摘　　要：目的探讨颅颌面巨大肿瘤联合切除术围手术期的护理经验。方法对2010年3月至2012年2月中山大学附属口腔医院收治的颅颌面巨大肿瘤切除术8例进行全面分析,总结其围手术期护理经验、病情监测的重点及并发症的防治。结果本组8例患者,其中1例术中因大出血出现休克,经配合紧急输血及止血处理后顺利完成手术;1例发生术后脑脊液耳漏,通过保守治疗及相关护理未并发颅内感染;1例术后眶周局部创口回流障碍,及时发现并对症处理后肿胀缓解;1例术后抽出鼻部填塞碘仿纱条后出现局部创口出血。全部患者术后创口均Ⅰ期愈合,未出现颅内高压及呼吸道梗阻窒息等严重并发症,无手术相关死亡,均康复出院。结论颅颌面巨大肿瘤联合切除术涉及多学科领域需鼻咽喉-头颈外科、神经外科、眼科、口腔科、整形修复外科等多学科共同合作,其临床护理特点是多学科的综合护理。充分的术前准备、密切的术中配合、严密的术后观察、及时有效的处理病情变化等全程细心的护理是手术成功的关键。Objective This paper aimed to summarize our experience of peri-operative care in resections of giant craniomaxillofacial tumors. Methods From March 2010 to February 2012, 8 patients underwent craniomaxillofacial giant tumor resections in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University. Peri-operative care and monitoring, as well as prevention and cure of complications in these cases were summarized. Results All wounds were healed primarily in these 8 cases. Post-operative cerebrospinal rhinorrhea happened in one patient. Wound bleeding was observed in one patient after pulling out the packed iodine gauze in wound cavity. All these complications were appropriately treated and all patients recovered and discharged with no severe complications. Conclusions Resection of craniomaxillofacial giant tumor is a team work with muhidisciplinary cooperation, including E.N.T.-head and neck surgery, neurosurgery, ophthalmology, maxillofacial surgery and reconstructive surgery. Multidisciplinary comprehensive peri-operative care is also important. Sufficient pre-operative preparations, accurate cooperation in surgery, close post-operative observation, as well as timely and effective treatment, contribute to the success of surgery.

关 键 词：颅颌面肿瘤 切除术 护理 

分 类 号：R473.73[医药卫生—护理学]