喉癌术后并发咽瘘的影响因素分析及护理策略

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1、喉癌术后并发咽痿的影响因素分析及护理策略［摘要］目的分析影响喉癌术后并发咽痿的危险因素，探讨针对性护理策略。方法收集248例喉癌手术患者完整临床资料，依据术后是否并发咽痿分析影响因素，总结护理策略。结果不同年龄、不同临床分期、是否合并糖尿病、不同营养状况的患者术后咽痿发生率比较，差异均有统计学意义（P均〈0.05）。不同手术方式、是否术前放疗、是否术前气管切开、不同手术时间、是否颈部淋巴结清扫的患者术后咽痿发生率比较，差异均有统计学意义（P均＜0.05）o是否术后并发感染、不同鼻饲时间、是否咳嗽、营养支持是否达标的患者术后咽痿发生率比较，差异均有统计

2、学意义（P均〈0.05）。术前营养状况、术前放疗、颈部淋巴结清扫、术后并发感染是术后并发咽痿的独立危险因素（P均〈0.05）。结论喉癌患者术后并发咽痿与疾病、手术、术后多种因素冇关，营养状况差、术前放疗、手术范围大及感染等是主要的因素，积极针对相关因素实施预防护理，对降低术后并发咽痿，改善预后有重要意义。［关键词］喉癌；并发症；咽痿；相关因素；临床护理［中图分类号］R739.65［文献标识码］B［文章编号］1673-9701(2013)32-0029-03Laryngealcancerpostoperativepharyngealfistulafac

3、torsandnursingstrategyZHOUYangpinglZHAOMing21.HeadandNeckSurgery,ZhejiangCancerHospital,Ilangzhou310022,China；2.ENT,theSecondHospitalofJ订inUniversity,Changchun130641,China[Abstract]ObjectiveToanalyzetheimpactof1aryngealcancerpostoperativepharyngealfistulariskfactors,discussspec

4、ificcarepolicies.MethodsAtotalof248casesoflaryngealcancerpatientsundergoingcompleteclinicaldata,basedonanalysisofpostoperativepharyngealfistulacomplicatingfactors,summedcarepolicies.ResuItsDifferentages,differentclinicalstages,whetherdiabetes,differentnutritionalstatusofpatient

5、stheincidenceofpostoperativepharyngealfistula,thedifferenceswerestatisticallysignificant(P<0.05)・Thedifferenceofdifferentsurgicalapproach,whetherpreoperativeradiotherapy,whetherpreoperativetracheotomy,differentoperativetime，whethercervicallymphnodedissection,thedifferentwaysofp

6、ostoperativedrainagepharyngealfistularatewerestatisticallysignificant(P<0.05)・Thediffereneeofwhetherpostoperativeinfection,differentfeedingtime,whethercoughing,whetherthetargetofnutritionalsupportinpatientswithpostoperativepharyngealfistularatewerestatisticallysignificant(P<0.0

7、5)・Preoperativenutritionalstatus,preoperativeradiotherapy,neckdissection，postoperativepharyngealfistulapostoperativeinfectionwereindependentriskfactors(P<0.05)・ConclusionPostoperativelaryngealandpharyngealfistuladisease,surgery,avarietyoffactors,poornutritionalstatus,preoperati

8、veradiotherapy,surgeryrangeandinfectionarethermiinfac