喉癌切除术患者围手术期综合护理体会

PERIOPERATIVE COMPREHENSIVE NURSING OF PATIENTS WITH LARYNGECTOMY

目的 总结对喉癌手术患者的综合护理经验，提高手术成功率。方法52例喉癌患者围手术期全部进行综合护理，对可能发生并发症的患者及早采取相应的护理措施。结果刀口Ⅰ期愈合50例，延期愈合2例，其中1例术后4d切口感染，经治疗10d后痊愈，另1例为糖尿病患者，经配合治疗糖尿病，刀口愈合良好。无1例发生咽瘘。除10例全喉切除患者外，其余42例均恢复发音功能，术后12～20d恢复讲话者36例，有4例经术后发音训练指导，在2～3周出院之前能自主讲话，发音较轻，吐字较连贯，另2例经4～8周练习恢复了讲话交流能力。术后10d能正常进食水者46例，轻度呛咳4例，经过1周后正常进食，中到重度呛咳2例。结论术前、术后做好相应的护理，注意患者心理和情绪的变化，取得患者合作和信任，预防气管切开并发症是手术成功的重要因素。

Objective To summarize the nursing of patients with laryngectomy to improve the curative effects. Methods Perioperative comprehensive nursing measures were taken to cope with the potential complications after laryngectomy. Results 50 patients got complete healing at Stage I, and the other 2 cases got delayed healing. One case got wound infection 4 days after operation and recovered 10 days later. Another case of diabetes got healing after relative treatment. No fistula occurred in any case. 10 cases got complete laryngectomy. Others all regained the function of producing sounds. 36 cases could speak 12 to 20 days after operation, and others needed training of pronunciation. 4 cases could speak freely but slightly. Two other cases regained speaking ability after 4 to 8 weeks of training. 46 cases could take in water 10 days after operation. Only 4 cases had slight choking and coughing, and could take in food. Two cases suffered from moderate or severe choking and coughing. Conclusion Good preoperative and postoperative nursing, paying attention to patients＇ emotional and mental changes, the cooperation between the medical staff and patients and the prevention of the complications are the keys to successful operations.