口腔颌面头颈肿瘤术后康复护理专家共识

Expert consensus on postoperative rehabilitation nursing of patients with head and neck cancer

口腔颌面头颈肿瘤患者的肿瘤部位及大小、治疗方式以及预后情况会对其口腔功能及颈部活动产生重要影响,进而影响进食、言语、上肢运动等日常活动。口腔颌面头颈肿瘤术后早期康复可以加快功能恢复、缓解不适症状、提升生活质量、减少不必要的康复或治疗措施。制定口腔颌面头颈肿瘤临床康复护理路径,形成个体化康复方案,及早有效地开展护理干预,是当今口腔颌面头颈肿瘤临床工作的重点之一。目前国内外指南或共识较少关注言语功能、咀嚼吞咽功能、颈肩功能等方面的障碍,缺乏系统全面的康复护理指南或共识为口腔颌面头颈肿瘤护理提供实践指导。上海交通大学医学院附属第九人民医院组织北京、上海、四川、陕西、浙江、安徽的多位专家,参考以往相关文献,并结合临床护理一线的技术与经验,共同撰写《口腔颌面头颈肿瘤术后康复护理专家共识》,以期对口腔颌面头颈肿瘤患者在口腔护理、营养支持、皮瓣供区护理、气管切开护理、咀嚼吞咽康复、言语功能康复、颈肩功能康复、张口受限康复、风险识别与防范、随访方面提供技术指导。

The location and size of tumors,treatment methods and prognosis of patients with head and neck cancer can seriously affect their oral function and neck activity,thereby affecting daily activities such as eating,speech and upper limb movement.Early rehabilitation after head and neck cancer surgery can accelerate functional recovery,alleviate discomfort symptoms,improve quality of life,and reduce unnecessary rehabilitation or treatment measures.Developing a clinical rehabilitation nursing pathway for head and neck cancer,forming personalized rehabilitation plans,and conducting early and effective nursing interventions are currently one of the key points of clinical work for patients with head and neck cancer.At present,domestic and foreign guidelines or consensus pays less attention to the impairments of speech function,chewing and swallowing function,neck and shoulder function etc.,and lacks a systematic and comprehensive rehabilitation nursing guide or consensus to provide practical guidance for the care of patients with head and neck cancer.Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine organized relevant experts from Beijing,Shanghai,Sichuan,Shaanxi,Zhejiang and Anhui to draft Expert consensus on postoperative rehabilitation nursing of patients with head and neck cancer basing on previous literature and clinical nursing skills and experiences,of which the aim is to provide guidance for those patients in the aspects of oral care,nutritional support,flap donor area care,care after tracheotomy,chewing and swallowing rehabilitation,speech function rehabilitation,neck and shoulder function rehabilitation,restricted mouth opening rehabilitation,risk identification and prevention and follow-up.