6例胃肠道肿瘤术后并发韦尼克脑病患者的护理

Nursing of cancer patients with Wernicke encephalopathy after gastrointestinal surgery

目的总结胃肠道肿瘤术后并发韦尼克脑病患者的护理经验。方法回顾性分析2013年1月-2015年6月本院收治的6例胃肠道肿瘤术后并发韦尼克脑病患者的临床资料,并总结护理要点。结果 6例患者均出现不同类型精神症状。6例患者中分别有5例出现眼部症状;1例出现特征性意识障碍、眼肌麻痹、共济失调三联征;1例出现周围神经系统痉挛;2例出现循环系统症状。患者均于确诊后实施肌内注射维生素B1治疗,其中4例症状完全缓解,2例症状部分缓解。结论在胃肠道肿瘤患者围手术期及时足量补充维生素B1是预防和治疗韦尼克脑病的关键措施。严密观察患者精神状态的变化以及对其特征性＂三联征＂采取针对性的护理措施是护理重点。

Objective To summarize the experience of nursing cancer patients with Wernicke encephalopathy（WE） after gastrointestinal surgery. Method The clinical data of 6 patients with WE after gastrointestinal surgery in our hospital from January2005 to June 2015 were retrospectively analyzed to summarize the nursing strategies. Results All the 6 patients showed mental changes of different types, 5 patients developed with ocular manifestations and one patient with ataxia. Only one patient showed the classic triad of the disease at clinical presentation. All the 6 patients had characteristic manifestations on cranial MRI and received thiamine（vitamin B1） at diagnosis. Four patients were completely recovered and 2 were partially recovered. Conclusion Timely sufficient thiamine supplementation during the perioperative period is the key to prevent and treat WE in the patients with gastrointestinal cancer. Careful observation of the patients′ mental state and the effective nursing for the special classic triad of the disease are critical for a better prognosis.