头颈部肿瘤术后颈部大血管破裂出血的预防与抢救

Nursing about prevention and rescuing of fatal bleeding induced by breaking of major cervical vessels after the operation of head and neck tumors

目的探讨头颈部肿瘤术后颈部大血管破裂出血的预防及抢救护理方法。方法回顾性分析2003年10月-2007年1月6例头颈部肿瘤术后颈部大血管破裂患者的护理过程：大血管破裂前的观察、预防措施,破裂时的救护及术后的护理。结果6例患者中4例抢救成功,2例死亡。无护理并发症发生。结论头颈部肿瘤术后颈部大血管破裂出血的预防及抢救护理包括以下几个方面：1）预防切口感染,给予营养支持,促进切口愈合是预防大血管出血的关键;2）避免诱发大血管破裂的因素,发现破裂先兆时充分准备,制定大血管破裂抢救的应急预案;3）做好患者的心理护理,缓解患者的紧张、烦躁情绪;参与有效的救护;4）患者抢救成功后,做好颈部大血管栓塞、结扎后的观察、护理。

Objective To investigate the nursing care about prevention and rescuing of fatal bleeding induced by breaking of major cervical vessels after the operation of head and neck tumors and the methods of rescuing and nursing.Methods The nursing processes of six cases with bleeding induced by breaking of major cervical vessels after the operation of head and neck tumors from October 2003 to January 2007 were analyzed retrospectively,including the intensive observation and prevention before breaking,the rescuing during breaking and the nursing care after the operation.Results Four of the six cases were successfully rescued,while the other two died.No nursing complication happened.Conclusions Nursing,prevention and rescuing of fatal bleeding induced by breaking of major cervical vessels after the operation of head and neck tumors should focus on： 1.Preventing the infection,giving the nutritional support and promoting the healing were the key points for preventing the breaking of major cervical vessels;2.Avoiding the inducements of breaking,preparing carefully when finding the foreboding of breaking,and establishing the emergency plan for rescuing of breaking of major cervical vessels;3.Doing well the mental nursing to relieve the tension and fidget,and participating in the efficient rescuing;4.Taking part in the observation,nursing and treatments of embolism and ligature of major cervical vessels after effective rescuing.