术前强化口腔护理在鼻咽癌手术患者中的应用

刘常平

【摘要】目的 探讨术前强化口腔护理在鼻咽癌手术患者中的应用效果。方法 根据纳入标准,选择确诊为鼻咽癌残灶或复发灶，拟行手术治疗的患者94例，随机分为实验组和对照组，试验组术前进行包括早期鼻腔冲洗及个体化口腔护理、口面颈部肌肉功能锻炼、咳嗽打喷嚏的应对方式、健康教育及心理护理的早期强化口腔护理方法，对照组进行常规护理。于术后记录口腔切口感染发生率，术后3个月随访患者洼田饮水试验、患者的张口情况、颈部活动情况等。 结果 实验组患者的术后术后创面感染发生率低于对照组，术后3个月吞咽障碍、张口困难的发生率低于对照组。结论 术前进行强化口腔护理的方法可以降低鼻咽癌术后感染以及吞咽障碍、张口困难的发生率，值得在临床上推广。

【关键词】鼻咽癌；围手术期；口腔护理；功能锻炼

【Abstract】Objective: To investigate the effects of preoperative strengthen oral care in patients with nasopharyngeal carcinoma surgery. Methods: based on the inclusion criteria, 94 patients who were diagnosed with residual lesions or recurrent nasopharyngeal carcinoma lesions were selected, and were randomly divided into experimental group and control group, the experimental group Was implemented preoperative strengthen oral care, including early preoperative nasal irrigation and individual oral care, orofacial neck muscle function exercise, ways to deal with coughing and sneezing, health education and psychological care. Record incidence of oral cavity wound infection after surgery and Kubota water drinking test results, the patient's mouth opening situation, neck movements after 3 months follow-up. Results: incidence of postoperative wound infection and 3 months dysphasia, difficulty in opening mouth in patients in experimental group were lower than the control group. Conclusion: Preoperative intensive oral care methods can reduce postoperative infection and nasopharyngeal dysphagia, truisms incidence; it is worth in clinical practice.

【key words 】 Nasopharyngeal Carcinoma; Preoperative; Oral Care; Functional Exercise

【中圖分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2014)07-0229-01

放射治疗是鼻咽癌的首选治疗方法，但是放射治疗后出现局部病灶残留以及复发的比率为10%，这部分患者再程放疗的效果不明显，且会出现严重的放疗反应。近年来，手术治疗作为放射治疗失败后的一种挽救性治疗方法，已广泛应用于鼻咽癌患者，但由于患者经历了长时间的放化疗，口腔情况欠佳，且手术风险大、并发症多，因此，如何使患者保持适宜的状态进入手术，为鼻咽癌手术的护理工作提出了更高的要求，我科室自2012年以来，对鼻咽癌手术患者实施了早期强化口腔护理，取得良好效果，现报告如下。……