2例自体游离空肠移植重建咽和颈段食管治疗晚期下咽癌围手术期护理

Peri-operation nursing on two patients who suffered advanced hypopharynx cancer and were treated with replanting jejual free flap to reconstruct pharynx and cervical esophagus

目的探讨自体游离空肠移植重建咽和颈段食管治疗晚期下咽癌病人的护理方法。方法手术前实施有效的心理护理、加强口腔护理、重视胃肠道准备;术后密切监测生命体征、保持引流管道通畅、做好胃造瘘及腹部伤口护理;及时进行有效的语言康复训练。结果2例接受该手术的晚期喉癌、下咽癌病人术后恢复良好,手术后未出现任何并发症,住院38d痊愈出院。结论术前对病人进行准确的护理评估,制定切实可行的护理计划,并有重点地实施围手术期护理,可预防术后并发症的发生,能有效地促进病人的康复、提高其治愈率。

Objective To explore the nursing of the patients who suffered advanced hypopharynx cancer and were treated with replanting the jejual free flap to reconstruct pharynx and cervical esophagus. Methods Before the operation, the patients received effective psychological care as well as strengthened oral care, and were attached great importance to their gastrointestinal preparations. After the operation, their vital signs were monitored effectively and the drainage tubes were kept unblocked, and their gatrostomy and abdominal wound were cared cautiously, rehabilitation exercises of language were carried out timely and effectively. Results Two patients with advanced laryngeal cancer or hypopharyngeal cancer had accepted the operation and recovered well, and had no complications after the surgery. They were cured completely and leaved hospital in 14 days. Conclusions Evaluating patients exactly, establishing a feasible nursing plan before operation and focusing on the implementation of peri-operative care can prevent the postoperative complications and promote the patients’ rehabilitation effectively as well as improve their cure rate.