超高龄头颈肿瘤患者游离皮瓣修复术术后并发症的回顾研究及护理对策

doi:10.19439/j.sjos.2018.02.020

上海口腔医学 ›› 2018, Vol. 27 ›› Issue (2): 216-220.doi: 10.19439/j.sjos.2018.02.020

超高龄头颈肿瘤患者游离皮瓣修复术术后并发症的回顾研究及护理对策

王悦平, 陈一铭, 季彤, 洪淑文

上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科, 国家口腔医学疾病临床研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011

收稿日期:2017-06-01 修回日期:2017-07-25 出版日期:2018-04-25 发布日期:2018-05-14
通讯作者: 洪淑文,E-mail：912025390@qq.com
作者简介:王悦平（1980-）,女,本科,主管护师,E-mail：18121213995@163.com

Retrospective study on postoperative complications and nursing measure for the oldest old patients receiving free flap reconstruction with head and neck cancers

WANG Yue-ping, CHEN Yi-ming, JI Tong, HONG Shu-wen

Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center of Stomatology; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology. Shanghai 200011, China

Received:2017-06-01 Revised:2017-07-25 Online:2018-04-25 Published:2018-05-14

摘要/Abstract

摘要： 目的:回顾分析超高龄头颈肿瘤患者行游离皮瓣修复手术术后并发症的特点及护理措施。方法:纳入2005—2015年于我院口腔颌面头颈-肿瘤科接受游离皮瓣修复术,且年龄>85岁的头颈肿瘤患者的基本信息、临床治疗信息、护理记录。总结术后并发症的数量、类型、护理措施以及效果评价。使用SPSS17.0软件包分析并发症的相关因素。结果:最终纳入24例患者,其中男15例,女9例;中位年龄86岁。20例既往患有基础性疾病,ASAⅡ级18例,ASAⅢ级6例。中位手术时间420 min;中位术中失血量550 mL。16例接受术中气管切开术,中位住院天数23 d,术后死亡1例;术后外科相关并发症12例,内科相关并发症19例。结论:超高龄头颈肿瘤游离皮瓣修复患者,出现术后并发症的几率较高。完善的术前评估、详细的术后观察与对症护理措施,可将术后并发症的负面影响降至最低并改善患者预后。

关键词: 超高龄患者, 头颈肿瘤, 术后并发症, 护理对策

Abstract: PURPOSE: To analyze the postoperative complications and nursing measures for the oldest old patients with head and neck cancer, who received free flap reconstruction. METHODS: A retrospective study for oldest old patients treated in the department of Oromaxillofacial Head and Neck Oncology of our hospital from 2005 to 2015 was conducted. All patients with head and neck cancer received free flap reconstruction with age≥85 years were selected. Demographics, clinical, nursing information and prognosis were collected. SPSS 17.0 software package was used for data analysis. RESULTS: There were a total of 24 oldest old patients, among whom 15 were male and 9 were female. The median age was 86 years old, 20 patients had co-morbidity, 18 patients had ASA Ⅱ and 6 patients had ASA Ⅲ. The median operation time was 420 minutes, while the median intraoperative blood loss was 550 mL. 16 patients underwent tracheotomy, 9 patients suffered from postoperative surgical complications and 16 patients experienced postoperative medical complications. CONCLUSIONS: The oldest old patients with head and neck cancer have high possibility of postoperative complications. Preoperative assessment, accurate postoperative observation and nursing measures can reduce the negative impact of postoperative complications and improve prognosis effectively.

Key words: Oldest old patients, Head and neck cancer, Postoperative complications, Nursing measures

中图分类号:

R739.8

王悦平, 陈一铭, 季彤, 洪淑文. 超高龄头颈肿瘤患者游离皮瓣修复术术后并发症的回顾研究及护理对策[J]. 上海口腔医学, 2018, 27(2): 216-220.

WANG Yue-ping, CHEN Yi-ming, JI Tong, HONG Shu-wen. Retrospective study on postoperative complications and nursing measure for the oldest old patients receiving free flap reconstruction with head and neck cancers[J]. Shanghai Journal of Stomatology, 2018, 27(2): 216-220.

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超高龄头颈肿瘤患者游离皮瓣修复术术后并发症的回顾研究及护理对策

Retrospective study on postoperative complications and nursing measure for the oldest old patients receiving free flap reconstruction with head and neck cancers

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