个体化导板辅助^(125)I放射性粒子植入治疗头颈部恶性肿瘤的手术护理

Intraoperative nursing care of individual template assisted iodine 125 seeds implantation for head and neck cancer

目的:探讨个体化导板辅助^(125)I放射性粒子植入治疗头颈部恶性肿瘤的手术护理措施。方法:2011年11月—2014年7月,我院为12例头颈部恶性肿瘤患者实施^(125)I放射性粒子植入术,术前制作个体化放射性粒子植入术护理评估量表,加强心理护理,熟练掌握放射性粒子植入术操作流程,术中协助固定个体化导板及头颈部,保证穿刺稳定性;做好手术环境放射监测及手术人员的安全防护等护理工作。结果:本组12例头颈部恶性肿瘤患者按计划完成治疗方案,随访时间11~35个月,总有效率达83.3%(10/12)。不良反应主要为放射性黏膜炎及皮炎、局部穿刺后出血、口干及吞咽困难等,均未见影响患者生活质量较大的3级及以上的急性和晚期放射性损伤发生。结论:个体化导板辅助^(125)I放射性粒子植入术的成功及良好疗效与护士的细心护理、精心配合与指导、密切观察病情是密不可分的。

Objective:To introdce the intraoperative nursing care during individual template assisted iodine125seeds implantation on advanced head and neck squamous cell cancer.Methods:Twelve patients diagnosed with head and neck cancers underwent iodine125seeds implantation.The key nursing care strategies include:make a detailed evaluation for each individual before the operation with an emphasis on psychological care,get familiar with the operational procedures of iodine125seeds implantation,assist in fixing the individual template and head,monitor the surroundings where the radioactive source is placed,exercise safety precautions during operation.Results:All cases accomplished the therapy of iodine125seeds implantation,the follow-up lasted for11-35months.The overall responding was83.3%(10/12).Major toxicities included radiation mucositis and dermatitis,local hemorrhage,xerostomia and dysphagia.No acute complications or treatment related radiation damages occurred in the trial.Conclusion:Individual template assisted iodine125seeds implantation is a safe and effective therapy for head and neck cancer,and it should be emphasized that personalized nursing,psychological guidance and close observation can ensure a successful operation and excellent effectiveness.