颈外动脉介入治疗面颈部肿瘤围手术期的观察与监护

Monitoring and nursing in perioperation for patients with maxillofacial and cervical tumor treated with external cervical artery intervening therapy

目的 :总结颈外动脉介入治疗面颈部肿瘤围手术期的监护经验。方法 :对 92例颌面及颈部肿瘤患者进行颈外动脉介入手术治疗 ,其中栓塞 30例 ,动脉灌注 42例 ,单纯造影 2 0例。术前重点做好心理护理 ,术中严密观察病情 ,尤其是造影剂反应、抗肿瘤药物反应、栓塞反应和有无并发症发生。术后做好不良反应的预防和处理。结果 :30例血管瘤 ,行永久性栓塞 5例 ,症状明显改善 ;行术前辅助性栓塞 2 5例 ,术中出血平均减少 75 % ;32例恶性肿瘤药物灌注后病情均不同程度缓解 ;造影定性诊治准确率达 93%。发生并发症 7例 ,占 7.6 % ,经处理 6例无后遗症 ,死亡 1例。结论 :对面、颈部肿瘤行颈外动脉介入手术治疗的患者 ,做好围手术期的观察与监护对提高疗效。

Objective: To review the effect of the treatment of maxillofacial and cervical tumor with external cervical atery intervention technique(ECAI). Methods: 92 cases of maxillofacial and cervical tumor were treated with ECAI. Therapeutic embolization was conducted in 30 cases, arteroy perfusion in 42 and opacification in 20. The patients were cared psycologically befor operation, monitored carefully in operation, especially for contrast medium responsing, antitumor drug responsing,embolisming responsing, etc. Results: Permanent embolization was achieved in 5 cases of hemangioma, bleeding was reduced by 75% in 25 cases treated with subsidiary embolization, local and general condition was improved in 32 patients with malignant tumor by perfusion of antitumor drug. Accuration of angiography was achieved in 93% of the cases. Complications were found in 7 cases and cured after treatment but in 1 who died of cerebrovascular disease. Conclusion: Perioperative monitoring is important to eliminate complications of ECAI.