经颈胸腹三切口食管胃同时性双原发癌围手术期护理  

Perioperative nursing care of simultaneous double primary cancer of esophagus and stomach through three incisions from the neck,chest and abdomen

作　　者：王梦霞 朱慧娣[1] 李贝贝[1] 江月红 徐巧英 Wang Mengxia;Zhu Huidi;Li Beibei;Jiang Yuehong;Xu Qiaoying(Gastrointestinal Surgery Department,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang,China)

机构地区：[1]浙江大学医学院附属第一医院胃肠外科,浙江杭州310003

出　　处：《加速康复外科杂志》2023年第4期188-192,共5页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

摘　　要：总结1例经颈胸腹三切口食管胃同时性双原发癌根治术围手术期护理体会。护理要点:组建加速康复外科多学科照护团队,提高并发症护理能力;严格肠道准备,做好结肠移植的术前护理;全程化肺康复方案的实施,防范肺部并发症发生;落实循证支持下的颈部吻合口瘘预防策略;早期识别移植结肠坏死。患者术后14 d出院,随访2个月,恢复良好。Summarize the perioperative nursing experience of a case of simultaneous double primary cancer of esophagus and stomach radical surgery through three incisions from the neck,chest,and abdomen.Nursing points:When undergoing radical surgery for esophageal and gastric cancer at the same time,the difficulty of digestive tract reconstruction surgery using colon as a substitute for esophagus increases,with high incidence rate of many complications.Nurses should thoroughly review surgical diagrams before surgery and combine them with the nursing management strategy of enhanced recovery after surgery(ERAS)to improve their ability to care for complications,give strict intestinal preparation and preoperative care for colon transplantation,implement a comprehensive lung rehabilitation plan to prevent pulmonary complications and evidence-based prevention strategies for cervical anastomotic fistula,early identification of transplanted colon necrosis,give follow up care after discharge.13 days after surgery,the patient was discharged and followed up for 2 months,showing good recovery.

关 键 词：颈胸腹三切口 结肠代食管 食管癌 胃癌 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]