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中国临床研究:2022,35(6):880-883
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内镜黏膜下剥离术治疗下咽及食管上段癌前病变和早癌的配合及精细护理
(南京中医药大学附属医院消化内镜中心,江苏 南京 210029)
Fine nursing cooperation of endoscopic submucosal dissection in the treatment ofprecancerous lesions and early cancer of hypopharynx and upper esophagus
(Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China)
摘要
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投稿时间:2022-02-03   网络发布日期:2022-06-20
中文摘要: 目的 总结内镜黏膜下剥离术(ESD)治疗下咽及食管上段癌前病变和早癌的术中配合及贯穿术程的精细护理。方法 对2017年2月至2021年11月南京中医药大学附属医院消化内镜中心接受ESD术治疗的下咽及食管上段癌前病变和早癌患者8例的临床护理资料进行回顾性分析。男性6例,女性2例,年龄(66.75±6.36)岁。术前:协助做好患者的术前评估和饮食、用药指导以及设备准备;术中:除协助麻醉和气管插管、摆放体位、协助进镜外,重点在病灶剥离过程中,根据术者指令,快速交换器械,实现剥离、止血、注射抬举的及时交替,直至大块完整切除病灶;术后:保持患者呼吸道通畅,严密观察生命体征、防止并发症,做好综合护理。 结果 8例患者手术过程顺利,术中无护理配合失误,无不良反应发生,均一次性成功完成ESD手术,治愈性切除率100%。护理干预结果良好:患者疼痛评分3分,术后下床活动情况良好,患者及家属满意度100%。所有患者术后均无严重并发症发生。结论 ESD治疗下咽及食管上段癌前病变和早癌,高效密切的术中配合及贯穿术程的精细护理是保证手术成功及患者康复的重要环节。
Abstract:Objective To summarize the intraoperative coordination and fine care of endoscopic submucosal dissection (ESD) for the treatment of precancerous lesions and early cancer of hypopharynx and upper esophagus. Methods A retrospective analysis was performed on the clinical nursing data of 8 patients with precancerous lesions and early cancer of hypopharynx and upper esophagus receiving ESD in the Affiliated Hospital of Nanjing University of Chinese Medicine from February 2017 to November 2021 [2 females and 6 males, aged (66.75±6.36) years]. Before operation, nursing focused on assisting preoperative evaluation, diet and medication guidance and equipment preparation. During the operation, in addition to assisting in anesthesia, endotracheal intubation, body position and endoscopy, nursing focused on the rapid exchange of instruments according to the operator’s instructions to realize the timely alternation of stripping, hemostasis and injection for lesion-lifting until the large lesion was completely removed. After operation, nursing focused on keeping the patient’s respiratory tract unobstructed, closely monitoring vital signs, preventing complications and doing a good job in comprehensive nursing. Results The operation process was smooth in 8 patients, and ESD was successfully completed at one time, without fault in nursing cooperation during operation. The rate of curative resection was 100%. Nursing interventions were effective for the patient’s pain score evaluation (3 points), out-of-bed activities and the satisfaction degree of patients and their families (100%). No serious complications occurred after surgery. Conclusion In the treatment of precancerous lesions and early cancer of hypopharynx and upper esophagus by ESD, intraoperative close cooperation and fine nursing are the important links to the success of operation and the safe rehabilitation of patients.
文章编号:     中图分类号:R473    文献标志码:B
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引用文本:
李红侠,黄娟娟,凌亭生.内镜黏膜下剥离术治疗下咽及食管上段癌前病变和早癌的配合及精细护理[J].中国临床研究,2022,35(6):880-883.

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