经颈前路喉钛网支架重建+钛板固定术喉癌患者的护理分析

Nursing analysis of larynx patients with anterior cervical titanium mesh stent reconstruction and titanium plate fixation

目的分析经颈椎前路钛网椎间植入+钛板内固定术喉癌患者的护理情况。方法选择2015年1月~2017年2月至我院进行经颈椎前路钛网椎间植入+钛板内固定术喉癌患者58例作为研究对象。所有患者均给予颈椎前路钛网椎间植入+钛板内固定术。术前给予患者心理护理、疼痛护理及进行充分的术前准备。术后给予常规护理,观察患者喉部神经并发症的发生情况。术后1d在患者身体允许的情况下指导患者进行四肢肌肉运动,第2d开始全身功能锻炼。结果所有患者术后切口均I期愈合,无术后感染发生。随访6个月,纤维喉镜下见患者上皮覆盖情况良好,未见明显肉芽生成,未见内固定松动、脱出情况发生。患者6个月呼吸功能恢复情况明显优于3个月时,患者6个月吞咽功能恢复情况明显优于3个月时,患者6个月发音功能恢复满意率为70.69%,明显高于3个月41.38%,且差异有统计学意义(P<0.05)。结论经颈椎前路钛网椎间植入+钛板内固定术是一项成熟的喉部和气管重建术式,良好高效的护理能够使患者更好的恢复健康,使患者有良好的预后。

Objective To analyze the nursing status of of larynx patients with anterior cervical titanium mesh stent reconstruction and titanium plate fixation.Methods From January2015to February2017,58patients with anterior cervical mesh titanium mesh and titanium plate fixation in our hospital were selected as the subjects.All patients were treated with anterior mesh titanium mesh and titanium plate fixation.The patients were given preoperative psychological care,pain care and adequate preoperative preparation.Routine nursing was given after the operation and the occurrence of nerve complications in the larynx were observed.After the operation one day,the patient was instructed to perform the movement of the limbs muscles under the condition of the patient's body,and the whole body began to exercise at the beginning of the second days.Results All patients were healed at I stage after operation,and no postoperative infection occurred.All patients were followed up for6months.The epithelial coverage of the patients under the fiberoptic laryngoscope was good,no obvious granulation formation occurred,and no loosening or prolapse occurred.The recovery of respiratory function in6months was obviously better than that of3months,and the recovery of swallowing function in6months was significantly better than that of3months,the satisfaction rate of the patients'pronunciation function recovery in6months was70.69%,which was significantly higher than that of3months(41.38%),and all had statistical difference(P<0.05).Conclusion Anterior cervical mesh titanium mesh and titanium plate fixation is a mature method for reconstruction of larynx and trachea.Good and efficient nursing can make the patient better restore health and make the patient have a good prognosis.