护理干预在腮腺肿瘤术后预防涎瘘中的作用.docVIP

腮腺肿瘤术后涎瘘的观察与护理 卢潇潇 周迎春 （重庆市肿瘤研究所头颈科 重庆 400030） [摘要] 总结腮腺肿瘤术后患者预防涎瘘发生的护理体会。对60例腮腺肿瘤术后患者在术前做好心理护理及术前准备；术后进行饮食干预禁食辛辣刺激性食物，特别是酸性食物；妥善固定负压引流管，保持引流管的通畅及负压引流器的负压状态；术区给予弹力绷带加压包扎。术后康复期配合医生观察患者耳下或耳后区有无肿胀，肿胀是否随进食咀嚼运动而增加，穿刺时是否可抽出容量不等的清亮液体。如术后出现耳下或耳后区肿胀，则立即通知医生，经对症治疗及精心护理，帮助患者及早康复。 [关键词] 腮腺肿瘤；涎瘘；护理 Parotid gland tumor postoperative salivary fistula of prevention and nursing Lu Xiao Xiao Zhou Ying Chun Chongqing cancer hospital, Head and Neck Surgery [Abstract] Summary of parotid gland neoplasms patients with postoperative prevention salivary fistula occurred nursing experience. On the 60 cases of parotid gland tumor after operation in patients with preoperative psychological nursing and to preoperative preparation, In the diet intervention fast spicy excitant food, especially acid food; Properly fixed negative pressure drainage tube, keep drainage tube patency and negative pressure drainage device negative state, Operation zone to elastic bandage compression bandage. Postoperative rehabilitation period with the patients were observed under the ear or ear hind area for swelling, swelling whether eat chewing movement with increased, puncture whether can spare capacity unequal colored and clear liquid. The 60 cases of parotid gland tumor patients with postoperative by symptomatic treatment timely advance nursing intervention, the no case was for eating problems and postoperative nursing undeserved and cause salivary fistula occurrence, reduce the salivary fistula rate, will promote the patient rehabilitation. [Key word] Parotid gland tumor; Salivary fistula, Nursing 腮腺肿瘤是口腔颌面部外科常见肿瘤疾病，目前主要的治疗方法为手术切除 [1]。涎瘘是腮腺肿瘤术后常见并发症，其判断标准为：术后耳下或耳后区轻度肿胀，伴或不伴有波动感，穿刺可抽出容量不等的清亮液体，并随进食咀嚼运动而增加[2]。涎瘘不仅影响美观，加重患者的心理负担,从瘘口流出的大量唾液也会在伤口局部造成刺激，引起皮肤红肿、瘙痒、甚至糜烂，影响手术切口愈合，延长手术切口包扎的时间,给患者造成了巨大的痛苦[3] 。我科对2010年1月-2012年1月60名腮腺肿瘤患者进行护理干预，现将涎瘘发生情况及护理经验报告如下。 1 临床资料 本组60例患者，其中男性32例，女性28例，年龄4—72岁，平均年龄39岁。良性肿瘤45例，其中腮腺混合瘤30例，腮腺囊肿10例，腮腺血管瘤5例；恶性肿瘤15例，其中粘液表皮样癌8例，腺样囊性癌5例，恶性混合瘤2例。位置：位于耳垂后及耳垂后下40例，耳前区10例，腮腺深叶10例。本组6