经鼻咽旁插植后装近距离加量放疗鼻咽癌的护理

目的观察经鼻咽旁插植后装近距离加量放疗鼻咽癌的疗效及总结护理要点。方法2005年9月～2006年9月对23例鼻咽癌患者进行经鼻内镜鼻咽、咽旁插植后装放疗,配合做好插植前、中、后的护理。结果患者均成功将施源器准确插入肿瘤区,插植位置100%合格,术后未发生大出血、感染等手术并发症及腭穿孔、鼻咽坏死等严重后装放疗并发症;随访3～15月肿瘤消失,无肿瘤局部复发,无远处转移。结论经鼻内镜鼻咽、咽旁插植组织近距离放射治疗效果好,插植前应做好患者的心理护理及熟悉手术配合的要领;术中密切观察患者的生命体征,预防患者鼻腔出血并保持呼吸道通畅;术后加强后装放疗并发症观察及预防,可确保患者顺利进行治疗。

Objective To study the curative effect of interstitial brachytherapy on nasopharynx and parapharynx tumors in patients and summarize the experience of caring them. Results 23 nasopharyngeal carcinoma patients during Sept.2005 to Sept. 2006 were treated with interstitial brachytherapy by inserting nasal endoscope into the tumor regions. Preoperative, intraoperative and postoperative cares were conducted. Results in all the patients. There were no complications of hemorrhea, The endoscope was successfully inserted into the tumor regions infections, palatal perforation and nasopharynx and pharyngeal necrosis. 3 - 15 months postoperative follow-up showed the tumors disappeared, without local relapse and distant metaptosis. Conclusions Interstitial brachytherapy by inserting nasal endoscope into the tumor regions is effective in treating tumors. The nursing care should include preoperational mental care and familiarization with cooperative key points for the surgery, intraoperative observation of vital signs and prevention against nasal bleeding and unobstructed respiratory tract, and postoperative close observation of complications induced by interstitial brachytherapy to ensure the smooth management.