壁式中心负压吸引在头颈部恶性肿瘤术后口底瘘中的应用

Application of wall-mounted central vacuum aspirator in nursing care of orocutaneous fistulas after operations on malignant head and neck tumors

目的探讨应用壁式中心的负压吸引系统在口底瘘的临床价值。方法 2008年12月～2011年10月应用壁式中心负压吸引处理6例头颈部恶性肿瘤术后口底瘘患者,总结瘘口上放置引流管及敷料的细节,报告运用的压力及成功率。结果 6例口底瘘在壁式中心负压吸引处理下均获成功。用壁式中心负压压力在100～125mmHg(13.33～16.67kPa),2例患者牙龈癌术后口底瘘分别5d、8d内愈合,1例口底癌术后、2例舌癌术后的口底瘘都是15d内愈合,1例舌癌术后口底瘘28d内愈合。6例口底瘘中3例感染,应用负压吸引的同时还需要全身应用抗生素。结论 负压吸引处理头颈部术后口底瘘,是头颈部恶性肿瘤完全切除术后瘘管处理的首选方法,能加速瘘管的愈合。

Objective To analyze the clinical benefit of wall-mounted central vacuum aspirator used in nursing orocutaneous fistulas. Methods 6 patients with orocutaneous fistulas after operations on head and neck tumors from December 2008 to October 2011 were managed with wall- mounted central vacuum aspirator. Their clinical data were retrospectively analyzed for summarizing the experience of using drainage tube and dressings on the fistulas, the used pressure and the success rate. Results 6 cases recovered from orocutaneous fistulas after using wall-mounted central vacuum aspirator at the negative pressure 100 - 125 mmHg （ 13.33 - 16.67 kPa）. 2 of them had their orocutaneous fistulas recovered from operation on carcinoma of gingiva in 5 d and 8 d. 1 had his and 2 had their orocutaneous fistulas recovered from operations on carcinoma of mouth floor and on tongue cancer within 15 days and 1 had his fistulas recovered in 28 d. 3 of them had infection in the orocutaneous fistulas, which were treated with antibiotics while using wall-mounted central vacuum aspirator. Conclusions Wall-mounted central vacuum aspirator is a best choice for the management of orocutaneous fistulas after total removal of neck and head malignant tumors. It works efficiently to speed their healing of orocutaneous fistulas.