甲状腺围手术期优质护理

Good Perioperative Nursing for hyroid Surgery

目的讨论甲状腺患者围手术期护理措施及经验。方法对2004年6月-2012年12月收治的171例甲状腺手术患者的围手术期护理方法进行回顾性分析,并就护理要点进行经验总结。结果 171例甲状腺手术患者均获治愈。术后并发症发生率1.8%～9.9%,包括切口内出血16例(9.9%),甲状腺机能减退11例(6.4%),单侧喉返神经损伤5例(2.9%),术后呼吸困难和窒息4例(2.3%),甲状腺危象4例(2.3%),喉上神经损伤3例(1.8%)。经及时对症处理,并发症得到有效控制,预后良好。结论术前细致的准备、术中积极的配合、术后密切观察并及早发现并发症、恰当处置,同时强化对患者的健康教育,对提高甲状腺围手术期护理质量与改善患者预后具有重要意义。

Objective To discuss the clinical experiences and measures ofperioperative nursing for thyroid surgery. Methods We performed a retrospective study on the clinical data of perioperative nursing for 171 patients treated in our hospital from June 2004 to December 2012. All patients received thyroid surgery. And perioperative nursing points of top quality were summarized. Results All patients who received surgeries were cured. The total incidence of complication after surgery was 1.8%-9.9%, and complications included incision bleeding in 16 patients （9.9%）, hypothyreosis in 11 （6.4%）, unilateral recurrent laryngeal nerve damage in 5 （2.9%）, postoperative dyspnea and asphyxia in 4 （2.3%）, thyroid crisis in 4 （2.3%）, and superior laryngeal nerve damage in 3 （1.8%）. The perioperative nursing interventions were effective, and the prognoses of patients were good. Conclusion The perioperative care points of top quality include careful preoperative preparation, effective operative cooperation, close postoperative observation and proper health education of patients, and all these are of great significance for early management of surgical complications of thyroid diseases and improving the prognosis of patients.