下咽-食道同时性多原发癌伴Ⅲ度喉梗阻患者围手术期护理

Perioperative care of a patient with simultaneous multiple primary carcinoma of the hypopharynx-esophagus with third-degree laryngeal obstruction

总结1例下咽-食道同时性多原发癌伴Ⅲ度喉梗阻患者围手术期护理体会。针对患者气道高风险、病情进展迅速、肺部感染、全身营养状态差、运动功能衰弱等问题,采取气道梗阻风险预警及应急处理,阶段化实施肺保护性策略,以目标为导向的术前预康复营养管理,低负荷小强度个体化抗阻运动改善虚弱促进患者康复等措施。经过34 d的积极治疗与护理,患者病情稳定出院,出院后随访1个月,患者状态良好。

We summarized the perioperative care experience of a patient with simultaneous hypopharyngeal-esophageal multiple primary carcinoma with third-degree laryngeal obstruction.Aiming at the patient’s high risk of airway obstruction,rapid disease progression,pulmonary infection,poor general nutritional status,and weakened motor function,measures such as early warning and emergency management of airway obstruction risk,phased implementation of lung protective strategies,goal-oriented preoperative prehabilitation nutritional management,and low load and small intensity individualized antiobstruction exercises were taken to improve weakness and promote patient recovery.After 34 d of active treatment and care,the patient was discharged in a stable condition,and the patient was in good condition at 1-month follow-up after discharge.