1例大型听神经瘤术后合并吞咽功能障碍及顽固性恶心呕吐患者的护理体会.docVIP

1例大型听神经瘤术后合并吞咽功能障碍及顽固性恶心呕吐患者的护理体会 倪益益 陆巍 刘雪喻 朱竺枝 季娟 江苏大学附属医院神经外科 江苏省南京鼓楼医院护理部 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 后颅凹肿瘤患者易发生吞咽困难、呛咳、呼吸循环功能障碍等严重并发症, 且手术治疗后仍可引起上述症状, 影响患者康复。本研究回顾性分析了1例大型听神经瘤切除手术患者的临床资料, 总结康复护理措施。本例患者术后出现一定成的吞咽障碍和恶心呕吐症状, 通过对患者吞咽功能及恶心呕吐程度的科学评估, 进而采取针对性康复护理和中医药膳调护, 患者的吞咽功能恢复正常且能有效进食。 关键词： 听神经瘤; 吞咽障碍; 恶心; 呕吐; 饮食; 中西医结合护理; 推拿; 收稿日期：2017-08-12 Nursing management of patients with swallowing dysfunction and intractable nausea and vomiting after surgical treatment for acoustic neuroma:a case report NI Yiyi LU Wei LIU Xueyu ZHU Zhuzhi JI Juan Department of Neurosurgery, Affiliated Hospital of Jiangsu University; Department of Nursing, Nanjing Drum Tower Hospital; Abstract： Patients with posterior fossa tumors often suffer from severity complications such as swallowing dysfunction, choking and respiratory dysfunction even after receiving surgical treatment, leading to a poor rehabilitation.This study aimed to retrospectively analyze the clinical data of 1 patient undergoing removal of large acoustic neuroma, and to summarize the rehabilitation nursing management.The case had suffered the swallowing dysfunction and intractable nausea and vomiting after surgical treatment.The patient was able to take food after receiving the targeted rehabilitation care and Chinese medicinal diet intervention based on the assessment of severity of complications. Keyword： acoustic neuroma; swallowing dysfunction; nausea; vomiting; dietary; nursing of integrated traditional Chinese and Western medicine; massage; Received： 2017-08-12 后颅凹肿瘤是指生长在小脑幕下方小脑、脑干、第IV脑室及V~VIII颅神经的肿瘤, 约占颅内肿瘤总数的1/3。由于后颅凹肿瘤易压迫或直接侵害脑干及后组颅神经, 易出现吞咽困难, 饮食饮水呛咳, 呼吸循环功能障碍及意识变化等严重情况, 虽然可通过手术进行治疗, 但术后仍可引起上述症状, 不利于患者恢复。因此对于后颅凹手术患者应给予严密观察和科学的护理, 以提高手术成功率、加快术后康复。本研究回顾性分析了1例大型听神经瘤切除手术患者的临床资料, 该患者术后出现了吞咽功能障碍及顽固性恶心呕吐等严重并发症, 经过积极有效的护理干预和治疗, 患者康复出院, 现报告如下。 1 临床资料 患者, 女性, 65岁, 因“左耳听力下降两年余伴头晕耳鸣1月, 口周及舌面部麻木1周”入院, M RI示左侧桥小脑角 (CPA) 占位, 疑为听神经瘤, 肿瘤较大约3.3 cm×4.0 cm。入院体检:左侧共济失