64例半骨盆置换术患者的护理

Nursing of 64 patients undergoing hemipelvic replacement

总结了64例骨盆肿瘤患者行人工半骨盆置换手术的围手术期护理。手术前后加强心理护理、营养支持、疼痛护理,术后加强各种导管的管理,积极预防和控制脂肪栓塞、肺部感染、压疮、血管栓塞等术后并发症。本组经手术治疗,Harris评分从术前平均45.3分提高至77.4分,肿瘤患者功能状态Karnofsky评分(KPS)从术前平均37.9分提高到66.9分,患者髋关节功能和全身功能状态得到改善。本组术后出现1例肺部感染和1例失血性休克,均通过及时发现并予以相应处理后痊愈。精心的围手术期护理能够为骨盆恶性肿瘤患者手术成功及术后康复创造有利条件,减少和预防并发症的发生,使患者安全度过围手术期。

This paper summarizes the perioperative nursing of 64 patients undergoing hemipelvic replacement for treatment of pelvic tumors.The key points included preoperative psychological nursing,nutritional support and pain management,as well as postoperative management of various catheters,prevention and control of postoperative complications such as fat embolism,pulmonary infection,pressure ulcer,intravascular embolization.After the operation,Harris scores increased from 45.3 to 77.4,and Karnofsky Performance Status（KPS） increased from 37.9 to 66.9.The patients＇ hip function and body functions were improved obviously.Pulmonary infection and hemorrhagic shock occurred in one case,respectively.Both the cases were detected in time and recovered after treatment.Careful perioperative nursing for patients with pelvic cancer is important to the success of hemipelvic replacement and postoperative rehabilitation,which can reduce postoperative complications and ensure the patient safety in perioperative period.