13例头颈部恶性肿瘤行大隐静脉颈动脉置换术患者的围手术期护理  

Perioperative nursing in 13 patients with head and neck cancer undergoing resection of carotid artery and replacement with great saphenous vein

作　　者：戴丹丹 寇翠敏[1] 王晓雷[1] 孙宇 DAI Dan-dan;KOU Cui-min;WANG Xiao-lei;SUN Yu(Department of Head and Neck Surgery,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,China)

机构地区：[1]中国医学科学院肿瘤医院头颈外科,北京100021

出　　处：《中国肿瘤临床与康复》2021年第1期78-81,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨头颈部恶性肿瘤患者行大隐静脉颈动脉置换手术围手术期的护理方法。方法选取2018年9月至2019年12月间中国医学科学院肿瘤医院收治的13例头颈部恶性肿瘤行大隐静脉颈动脉置换术患者,在患者手术治疗前进成立多学科治疗小组、心理护理和颈总动脉压迫试验等术前护理,手术后采用术后护理,包括血压管理、病情观察、抗凝药物效果观察、体位护理、气道管理、营养管理、心理护理和并发症预防,分析总结头颈部恶性肿瘤患者行大隐静脉颈动脉置换手术的围手术期护理方法。结果 11例患者术后未出现脑卒中和偏瘫等严重并发症,均顺利出院;1例患者出现轻微脑梗塞,治疗观察四周后出院,1例患者出现急性心肌梗塞,转入专科医院治疗四周后顺利出院。结论对头颈部恶性肿瘤行大隐静脉动脉置换术患者行针对性围手术期护理,可提高手术成功率,减少术后并发症,促进患者康复。Objective To discuss the perioperative nursing in patients with head and neck cancer who underwent resection of carotid artery and replacement with great saphenous vein. Methods Thirteen patients with head and neck cancer who underwent resection of carotid artery and replacement with great saphenous vein were selected at Cancer Hospital,Chinese Academy of Medical Sciences from September 2018 to December 2019. A multidisciplinary team for treat was established to provide psychological nursing and preoperative nursing during carotid compression test. Postoperative nursing included blood pressure management,disease observation,observations on the effects of anticoagulants,posture nursing,airway management,nutrition management,psychological nursing and prevention of complication. Perioperative nursing strategies were analyzed in patients with head and neck cancer who underwent resection of carotid artery and replacement with great saphenous vein. Results Eleven patients were discharged successfully without serious complications such as stroke and hemiplegia. Mild cerebral infarction occurred in 1 patient who was discharged at 4 weeks after operation. Acute myocardial infarction occurred in 1 patient who was transferred to a specialist hospital for treatment and was successfully discharged 4 weeks later. Conclusion Strengthening perioperative nursing can improve success rate of operation and reduce postoperative complications in patients with head and neck cancer who underwent resection of carotid artery and replacement with great saphenous vein.

关 键 词：头颈部恶性肿瘤 大隐静脉移植 颈动脉置换术 

分 类 号：R739.41[医药卫生—肿瘤]