颈胸联合胸骨劈开术治疗胸骨后甲状腺癌患者的围手术期护理  

Perioperative nursing care for patients receiving cervical thoracic combined sternotomy for retrosternal thyroid cancer

作　　者：朱晓彤[1] 毛小燕[2] 吴梦雪 徐芳芳 Zhu Xiaotong;Mao Xiaoyan;Wu Mengxue;Xu Fangfang(Department of Thyroid Surgery,South Hospital District of Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510260,China;Department of Anaesthesiology,South Hospital District of Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510260,China)

机构地区：[1]中山大学孙逸仙纪念医院南院甲状腺外科,广东广州510260 [2]中山大学孙逸仙纪念医院南院麻醉科,广东广州510260

出　　处：《现代临床护理》2021年第11期47-51,共5页Modern Clinical Nursing

摘　　要：目的总结颈胸联合胸骨劈开术治疗胸骨后甲状腺癌患者的护理要点。方法2019年4月—2020年4月对本院收治的2例II型胸骨后甲状腺癌患者实施颈胸联合胸骨劈开术,护理人员配合做好围手术期护理工作。结果2例患者均顺利完成手术,手术时间分别为310 min、370min;术后住院时间分别为10 d、14d。术后1例老年患者发生肺炎、低钙血症、声音嘶哑;1例患者发生食管瘘、声音嘶哑与非计划性拔除胃管,经治疗护理,手术后10d与14d康复出院。结论术前做好患者手术前检查、控制基础疾病以及心理护理工作,术后做好病情观察、并发症防治工作等,其是保证患者顺利度过围手术期的重要措施。Objective To summarize the nursing points for caring of the patients who received cervical thoracic combined sternotomy for the retrosternal thyroid cancer.Methods From April 2019 to April 2020,two patients with type II retrosternal thyroid cancer admitted to our hospital and had cervical thoracic combined sternotomy.The nursing staff collaborated to carry out the perioperative nursing care.Results Both of the patients went through the operation smoothly,with 310 mins and 370 mins of operation duration,respectively.The postoperative hospital stays were 10 and 14 days,respectively.The elderly patient developed pneumonia,hypocalcaemia and hoarse voice after the surgery.The other patient developed oesophageal fistula and hoarseness and underwent unplanned withdraw of the gastric intubation.After treatment,both of the patients were recovered and discharged 10 to 14 days after the surgery.Conclusions Perioperative nursing measures such as preoperative examination,control of underlying diseases,psychological nursing,postoperative observation,and the treatment and prevention of complications are critical for ensuring the patients with retrosternal thyroid cancer to go through the surgical treatment smoothly for the cervical thoracic combined sternotomy.

关 键 词：胸骨后甲状腺癌 颈胸联合胸骨劈开术 围手术期护理 

分 类 号：R473.6[医药卫生—护理学] R473.73[医药卫生—临床医学]