70例经鼻蝶窦入路手术库欣病患者的多学科融合模式护理  

Multidisciplinary integration care of 70 patients with Cushing’s disease undergoing transsphenoidal surgery

作　　者：金煜峰[1] 殷志雯[1] 石卫琳[1] 唐书婕 张黎艳 JIN Yu-feng;YIN Zhi-wen;SHI Wei-lin;TANG Shu-jie;ZHANG Li-yan(ICU,Hongqiao Campus,Huashan Hospital,Fudan University,Shanghai 201401,China)

机构地区：[1]复旦大学附属华山医院虹桥院区重症监护室,上海201401

出　　处：《复旦学报（医学版）》2021年第5期703-706,共4页Fudan University Journal of Medical Sciences

摘　　要：回顾性分析复旦大学附属华山医院神经内分泌肿瘤一体化诊疗中心2018年12月至2019年11月入院的70例经鼻蝶窦入路手术库欣病患者的临床资料、手术治疗并发症及围手术期处理,总结多学科融合模式下经鼻蝶窦入路库欣病的护理。其中男性13例,女性57例,合并有肾上腺增生或腺瘤可能8例,促肾上腺皮质激素增高42例。临床多表现为向心性肥胖、皮肤紫纹及痤疮等体貌改变、高血压、高血糖及高胆固醇血症等,女性还存在闭经或月经不规则。术后内分泌功能低下61例、鼻腔渗血渗液56例、尿崩症41例、头痛33例、精神性惊恐发作1例,无护理相关并发症。全面评估、充分的术前准备、合并症及早期并发症防治是患者围手术期护理管理的重点。护士应在多学科融合团队中,结合循证护理及患者个体需求,提供全病程、有侧重的专病护理。To summarize the nursing effect of multidisciplinary integration care mode in Cushing's disease undergoing transsphenoidal surgery.The clinical data,complications and perioperative management of 70 patients who admitted during Dec 2018 to Nov 2019 in the neuroendocrine tumor treatment center of Huashan Hospital Affiliated to Fudan University were retrospectively analyzed.Among them,there were 13 males and 57 females,8 cases with adrenal hyperplasia or adenoma,and 42 cases with adrenocorticotropic hormone elevation.The clinical manifestations were centripetal obesity,purple striae of the skin,acne and other physical changes,hypertension,hyperglycemia and hypercholesterolemia,et al.Women also had irregular menstruation.There were 61 cases of postoperative endocrine dysfunction,56 cases of nasal wound discharge,41 cases of diabetes insipidus,33 cases of headache and 1 case of mental panic attack,no nursing related complications.Comprehensive evaluation,adequate preoperative preparation,prevention and treatment of complications and early complications are the key points of perioperative nursing management.Nurses in a multidisciplinary integration team should consider evidencebased nursing with individual needs of patients,and provide a full-course,focused disease care.

关 键 词：经鼻蝶窦入路手术 库欣病 多学科融合模式护理 

分 类 号：R736.4[医药卫生—肿瘤]