1例鼻咽癌颈部转移癌性包块患者的护理体会  

Nursing Experience of A Case of Nasopharyngeal Carcinoma with Cervical Metastatic Cancerous Mass

作　　者：张慧 余荣玲 师凌云[1] Zhang Hui;Yu Rongling;Shi Lingyun(Radiotherapy Department Jiangsu Cancer Hospital,Nanjing Jiangsu 210009,China)

机构地区：[1]江苏省肿瘤医院放疗科,江苏南京210009

出　　处：《生命科学仪器》2024年第3期218-220,共3页Life Science Instruments

摘　　要：总结1例鼻咽癌患者综合治疗5年后,左侧颈部发现10 cm×8 cm×4 cm转移性肿块,并出现破溃、流液、恶臭、疼痛、窦道形成等相关症状的综合护理体会。护理人员充分评估患者病情、治疗方案、疼痛程度、癌肿情况、营养状况、心理状况及家庭社会支持情况等,依据细菌培养及药敏试验结果,根据患者癌肿的不同进展阶段,采用多种清创方式清除表面的坏死组织,选用不同的冲洗液冲洗、敷料填塞、引流、覆盖癌肿间隙,以保护癌肿周围的皮肤,控制感染,去除异味,提高患者生活质量。通过给予患者癌肿伤口护理、疼痛管理、心理支持和鼓励,同时给予充足的营养支持等综合护理措施,患者顺利完成后续综合治疗。治疗83天后,患者左侧颈部的转移性肿块消退,未发生颈部皮肤及全身继发感染,恶臭消失、疼痛缓解,患者自觉效果满意。因此,针对难治性癌性病灶,需综合评估患者病情、治疗情况、营养状况、疼痛程度、病灶、感染情况、预后、个人需求等多方面因素,依据患者实际情况进行个性化综合护理干预,从而提高患者治疗配合度与生活质量。To summarize the comprehensive nursing experience of a nasopharyngeal carcinoma patient who found a metastatic mass of 10 cm×8 cm×4 cm in the left neck after comprehensive treatment for 5 years,and presented with ulcer、bleeding、odor、pain、sinus formation and other related symptoms.Nursing staff fully evaluated the patient's condition、treatment plan、pain degree、cancer、nutritional status、psychological status and family social support etc.According to the results of bacterial culture and drug sensitivity test,according to the different stages of cancer development,various debridement methods were adopted to remove the necrotic tissue on the surface,and different washing solutions were selected to wash、pack、drain and cover the cancer gap,so as to protect the skin around the cancer、control infection,remove odor and improve the quality of life of patients.Through comprehensive nursing measures such as cancer wound care、pain management、psychological support and encouragement,and adequate nutritional support,the patients successfully completed the follow-up comprehensive treatment.After 83 days of treatment,the metastatic tumor in the patient's left neck subsided,and no secondary infection occurred in the neck skin and whole body.The stench disappeared and the pain was relieved.The patient felt satisfied with the effect.Therefore,for refractory cancer lesions,it is necessary to comprehensively evaluate the patient's condition、treatment、nutritional status、pain degree,lesions、infection、prognosis、personal needs and other factors,and carry out personalized comprehensive nursing intervention according to the actual situation of patients,so as to improve the treatment cooperation and quality of life of patients.

关 键 词：鼻咽癌多发转移 癌性伤口 伤口护理 心理护理 

分 类 号：R473.73[医药卫生—护理学]