咽癌术后并发咽瘘的因素与护理对策

The Factors and Nursing Strategy of Postoperative Pharyngeal Fistula for Pharyngeal Cancer

目的:探讨咽癌术后并发咽瘘的发生因素与护理对策。方法:选取笔者所在医院2005年8月-2013年12月进行手术治疗的172例咽癌患者作为研究对象,所有患者均给予全喉切除结合下咽切除加颈清扫,观察预后情况,并与临床资料进行相关分析。结果:所有患者均完成手术,术后发生咽瘘13例,发生率为7.56%。相关性分析显示,影响咽癌术后并发咽瘘发生的独立危险因素主要为糖尿病、术后发热和疾病分型(P<0.05)。所有咽瘘患者经过对症干预与护理后均痊愈出院。结论:咽癌术后并发咽瘘比较常见,护理人员需要根据临床发病因素积极加强对症护理与干预。

Objective：To investigate the risk factors and nursing strategy of postoperative pharyngeal fistula for pharyngeal cancer. Method：172 pharyngeal cancer patients for surgery treatment from August 2005 to December 2013 in our hospital were selected,All patients were given total laryngectomy combined with hypopharyngeal resection and radical neck dissection,the prognosis and the clinical data were observed and analyzed. Result：All patients were completed the surgery,there were 13 cases of postoperative pharyngeal fistula occurred,the rate was 7.56%.Multivariate non-conditional Logistic regression analysis showed that independent risk factors affected postoperative pharyngeal fistula were mainly diabetes,postoperative pyrexia and disease type（P〈0.05）.All pharyngeal fistula symptomatic patients after intervention and care were discharged.Conclusion：The postoperative pharyngeal fistula pharyngeal cancer is more common,the nursing staff need to actively strengthen symptomatic care and intervention based on clinical risk factors.