5例多发性内分泌腺瘤2B型患者的围手术期护理

Perioperative nursing care of 5 patients with multiple endocrine neoplasia type 2B

目的探讨5例多发性内分泌腺瘤2B型(multiple endocrine neoplasia type 2B,MEN2B)患者的围手术期护理。方法选择2015年至2021年间浙江省杭州市第三人民医院和解放军第903医院诊治的5例MEN2B患者的临床资料,综合分析其临床特点,给予术前评估,提供个性化心理支持;术中密切观察配合手术进展;术后给予个性化的激素替代护理,积极预防并发症,制订详细的随访计划。结果双侧甲状腺切除术后,5例患者均接受甲状腺素替代治疗,其中2例患者还接受了一期双侧嗜铬细胞瘤切除,术后接受糖皮质激素替代。通过积极的护理干预,减少和避免了各种手术并发症的发生。结论个体化激素替代和心理支持护理、规范手术治疗、定期随访和严密监测是MEN2B患者获得较好预后的基础。

Objective To explore the perioperative nursing of 5 patients with multiple endocrine neoplasia type 2 B(MEN2 B). Methods The clinical data of 5 patients with MEN2 B who were diagnosed and treated in Hangzhou Third People’s Hospital and PLA 903 Hospital from 2015 to 2021 were selected. Their clinical characteristics were comprehensively analyzed, preoperative evaluation was given, and individualized psychological support was provided. During the operation, patients were closely observed to match the progress of the operation. After surgery, they were given individualized hormone replacement care, actively prevented complications, and formulated a detailed follow-up plan. Results 5 patients all received thyroxine replacement therapy after bilateral thyroidectomy, of which 2 patients also underwent bilateral simultaneous adrenal-sparing surgery for phaeochromocytoma, and 2 patient needed glucocorticoid replacement after operation. Active nursing intervention can reduce and avoid all kinds of surgical complications. Conclusions Individualized hormone replacement and psychological support nursing, standardized treatment, regularly follow-up and close monitoring of index changes have MEN2 B patients achieved a better prognosis.