1例颈静脉孔区咽旁间隙颅内外沟通瘤:迷走神经鞘膜瘤患者的术后护理  

A case of intracranial tumor outside communication in the anterior jugular area : postoperative care of patients with vagus nerve sheath tumor

作　　者：杨蓓 黄茂华 刘玲 李佳家 严琳潇 

机构地区：[1]第三军医大学第一附属医院(西南医院)耳鼻咽喉科,重庆400038

出　　处：《中国医学文摘（耳鼻咽喉科学）》2017年第4期216-218,共3页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的颈静脉孔是后颅底重要通道,内有重要的血管及神经通过。颈静脉孔区神经鞘瘤较少见,其中颅内外沟通型神经鞘瘤尤为少见。由于位置深在,周围结构复杂,术后可出现脑神经损伤和脑脊液漏等并发症。术后的精心护理对患者的预后起着非常重要的作用。方法简单介绍该病例病史及手术过程,再对患者术后护理进行详细的阐述,如患者术后体位管理,病情观察,持续生命体征监测,患者意识瞳孔肌力体温等变化,患者伤口渗血渗液情况,观察术后有无并发症,对患者术后出现的器质性精神障碍进行保护性约束并给予患者及家属心理护理。结果患者病情稳定,未发生颅内感染,意识清楚,经过康复训练,已健康出院。结论颈静脉孔区颅内外沟通瘤患者较少见,因其部位特殊,涉及重要神经血管,手术复杂,术后并发症多,使得术后很好的病情观察及各种并发症的预见性护理变得尤为重要。Objective Jugular foramen is an important channel of cranial base,with important vessels and nerves location. Jugular foramen schwannomas is rare,much less is Schwannoma with internal and external communication. Due to the depth and complexity,postoperative complications such as brain damage and leakage of cerebrospinal fluid may occur. Postoperative care plays a very important role in the patient＇s prognosis. Methods The history of the case and the operation process was introduced. Then was the detail of the progress of postoperative nursing of patients,such as postoperative position management,disease observation,continuous monitoring vital signs,pupillary muscle strength in patients with body temperature changes,wound ooze and blood drainage situation,observation of postoperative complications in patients with postoperative organic mental disorders,protective constraint and psychological nursing of both patient and his family. Results Patients are now in a stable condition,without the occurrence of intracranial infection,and has recovered from hospital. Conclusion Patients with intracranial tumors in jugular foramen region is relatively rare. Because of its special areas involving major nerve blood vessels,complex operation,postoperative complications,postoperative observation and predictive nursing of complications has become particularly important.

关 键 词：颈静脉孔区 颅内外沟通瘤 术后护理 

分 类 号：R739.4[医药卫生—肿瘤]