8例鼻脑毛霉菌病患者的临床特点分析及护理

Clinical features and nursing strategy of 8 patients with rhinocerebral mucormycosis

目的：探讨鼻脑毛霉菌病的临床特点及护理对策，提高对该病的认识以及该病的护理质量。方法回顾分析8例鼻脑毛霉菌病的临床过程，从患者的病程进展分析该病的临床特点以及护理措施。结果共收集8例患者，分别有糖尿病或酮症酸中毒、放疗史或贫血等全身免疫功能低下的前期基础，临床症状为头痛，出现眶尖综合征。对患者重点进行了局部体征观察、围术期颅内压及全身情况变化观察，药物不良反应观察及原发病护理及心理、基础护理，住院期间患者未发生相关护理事件，相应护理措施收到一定效果。1例在发病后1周死亡，4例存活3～12个月，3例仍存活，随访未见复发。结论鼻脑毛霉菌病是继发于全身免疫状态低下的严重疾病，病变累及眼眶和颅内，病情进展较快，死亡率高。早期发现，及早手术清理病灶、配合全身综合治疗和对应护理措施可延缓病程进展。

Objective To study the clinical features and nursing strategy of rhinocerebral mucormycosis , and to improve the knowledge of the disease and the quality of care .Methods The data of 8 cases with rhinocerebral mucormycosis were reviewed and analyzed .The clinical features and nursing intervention were analyzed throughout the course of disease .Results The underlying immunosuppressive condition of the 8 cases of mucormycosis had diabetes , diabetic ketoacidosis , anaemia or adiotherapy with headache and orbitial apex syndrome as the early symptoms .Nurses focused on local signs observation , perioperative change of intracranial pressure and general conditions , drug adverse reaction observation and nursing care of original disease , mental care, and basic nursing care .There were certain effects for corresponding nursing measures without occurrence of nursing events duration of hospital stay .1 patient died within one week in hospital;4 patients had survived from 3 to 12 months; and 3 patients had been alive over 3 years until now.Conclusions Rhinocerebral mucormycosis was the secondary onset severe diseases for patients with poor immunologic function , implicated in the orbit and brain , and the fatality rate was high .It could hold the development of the disease by clearing up the focus and wiping off the condition of fungi thrive together with medical management and adequacy nursing intervention .