目的:總結喉返神經修復重建術圍手術期的護理配合。方法：我科2007年10～11月手術治療雙側喉返神經麻痹患者3例，手術前加強患者的心理護理、密切觀察病情變化，及時處理聲帶麻痹引起的喉梗阻、誤吸、嗆咳等癥狀。術后重視體位護理、呼吸道的管理、保證藥物及時準確使用，協助患者進行正確的吞咽進食訓練、聲帶協調運動訓練等康復護理。結果：3例患者術后均獲完整隨訪，3月后均順利拔除氣管套管，無吸氣性呼吸困難，無發音困難，嗓音質量較術前明顯改善。結論：良好的圍手術期護理有助于手術的成功。
目的：比較常規鼻胃管置入法與鼻咽部局部噴霧麻醉后置胃管法對喉癌患者的影響。方法：將需要安置胃管的100例患者隨機分成兩組，每組50例。實驗組行鼻咽部噴霧麻醉，對照組按常規操作，比較兩組患者流淚、惡心、嘔吐、咳嗽反應，一次成功率及插管所需要時間、插入中暫停次數。結果：實驗組一次成功率高，患者反應輕，插管所需時間有顯著差異。結論：常規置胃管常因病員難受而中途暫停置管，實驗組置胃管前先作鼻咽部局部噴霧麻醉，可明顯減輕患者的痛苦，提高插胃管的一次成功率，插管過程中因病員難受暫停次數也明顯減少，使臨床護理工作時間縮短，對臨床護理工作有積極意義。
目的:探討改良氣管套管墊安置法對喉癌術后佩戴氣管套管、頸部傷口敷料加壓包扎期患者的適用性。方法:采用隨機分組的方法將38例喉癌術后佩戴氣管套管的患者分為傳統組20人和改良組18人, 傳統組采用“Y”型氣管套管墊,改良組采用“Y”型氣管套管墊,比較兩組患者在更換氣管套管墊時的SpO2值、SpO2降低值及刺激性咳嗽次數。結果:安置氣管套管墊的過程中,改良組SpO2值高于傳統組、SpO2降低值低于傳統組,且發生刺激性咳嗽的次數也低于傳統組,差異有統計學意義(Plt;0.01)。結論:與傳統氣管套管墊安置法相比,改良氣管套管墊安置法能減少患者換藥過程中刺激性咳嗽的次數,對SpO2值影響輕微,更適合于喉癌術后早期頸部傷口敷料加壓包扎患者的換藥。
ObjectiveTo understand the application of the Braden pressure ulcer risk-factor assessment scale in the nursing staff, in order to provide reference for clinical nurses to standardize the use of Braden assessment scale and facilitate the hospital to develop training programs on pressure ulcer related knowledge. MethodsStratified cluster sampling method was applied in February 2015. Using the self-designed questionnaire of “Application of Braden pressure ulcer risk-factor assessment scale in the nursing staff ”, we conducted a survey on 198 clinical nurses, and the survey results were scrutinized. The difficulty level of using Braden assessment scale in the nurses was analyzed based on their different demographic characteristics. We also analyzed the items which were most difficult to judge for the nurses and nurses’ learning needs for knowledge on Braden assessment scale. ResultsA total of 168 (84.85%) nurses found it difficult in using Braden scale for the evaluation of pressure ulcer. The most difficult items to judge for the nurses were friction force, shear force and feeling. Nurses in departments with pressure ulcer as a common symptom of the patients could better use the Braden pressure ulcer risk-factor scale, compared with those in departments where pressure ulcer was uncommon (P＜ 0.05) . A total of 189 (95.46%) nurses thought it necessary to carry out a unified quantitative standard analysis of six risk factors in the Braden scale. Conclusions The poor mastery of the assessment standards for Braden scale in the nurses causes various degrees of difficulty in applying the scale, which can influence the accuracy of assessment. It is important to train the nurses on pressure ulcer risk factor assessment in order to raise the clinical assessment accuracy.