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        甲状腺癌毕业论文 甲状腺癌手术前后的护理体会

        版权:原创标记本站原创 星级:★★★★★3.0主题:甲状腺癌有活40年的吗范文 级别:优秀职称论文 范畴:本科学位论文 论文范文编号:biyelunwendq025715 期刊发表:职称评定 全文字数:2000字 投稿作者:efkcfh 审稿编辑:权威学术家 阅读次数:46979

        该文是甲状腺癌论文范文,为你的写作提供相关参考.

        甲状腺癌手术前后的护理体会【摘要】目的 总结并探讨甲状腺癌手术前后的护理措施。策略 回顾17例甲状腺癌患者从心理、术前准备、术后病情观察等方面的护理策略和效果。结果 通过全方面的护理帮助患者渡过危险期,1例患者并发乳糜漏,后均治愈出院。结论 对患者进行手术前后的综合护理,能有效减轻病情,推动疾病的恢复。

        甲状腺癌有活40年的吗论文 甲状腺癌有活40年的吗

        普通胰岛素治疗心外科糖尿病患者围手术期的护理体会

        甲状腺瘤手术患者应用护理干预的效果对其负性情绪的影响

        晚期甲状腺癌患者手术前后的护理

        胃穿孔患者的围手术期护理体会

        甲状腺癌手术前后的护理体会硕士论文开题报告相关参考属性
        有关论文范文主题研究: 关于甲状腺癌论文范文集 大学生适用: 10000字硕士毕业论文
        相关参考文献下载数量: 70 写作解决问题: 学术论文怎么写
        毕业论文开题报告: 论文任务书、论文摘要 职称论文适用: 期刊目录、高级职称
        所属大学生专业类别: 甲状腺癌有活40年的吗方面 论文题目推荐度: 优秀甲状腺癌选题

        【关键词】甲状腺癌,护理

        1004-4949(2014)12-0497-01

        甲状腺癌是颈部常见的恶性肿瘤之一,由于手术范围大,术后病情变化快,并发症发生率高,严重影响患者的顺利康复[1],因此加强手术前后的护理尤为重要。我科从2011.7-2012.12对17例甲状腺癌患者从生理、心理、病情观察等方面进行护理,加强手术前后的护理,疗效满意,现将护理体会总结如下:

        1.临床资料

        1.1 一般资料 本组17例患者均为甲状腺癌患者,均经术后病理证实,年龄在26-66岁,其中男性5例,女性12例,术后病理均为甲状腺 状癌,其中3例合并结节性甲状腺肿,2例合并淋巴细胞性甲状腺炎。

        1.2 治疗及转归 本组患者7例行双侧甲状腺全切除术,11例行甲状腺癌标准根治术,8例行颈淋巴结清扫术,1例并发乳糜漏,住院期间均给予整体护理治疗,从生理、心理,完善术前准备,严密观察术后病情,加强切口与引流管的观察及护理,重视术后并发症的观察及护理,后均痊愈出院。

        2.术前护理

        2.1 心理护理 患者常在无意中或体检中发现肿块,病史短而突然,或肿块已有多年突然增大,多担忧疾病的预后,表现出紧张、焦虑不安,所以对待患者应热情,使其尽快适应住院环境,多与其沟通,了解其心理状态,向其说明手术的必要性和术前准备的作用,,解除其思想顾虑,积极配合疾病的治疗。根据患者情况,遵医嘱予镇静安眠药,使其处于接受手术的最佳身心状态。

        2.2 术前准备 要指导患者进行体位锻炼,即将软枕垫于肩部,保持头低、颈过伸位,以利于术中手术野的暴露[2]。指导其掌握深呼吸、有效咳嗽的策略。指导其进食足够热量、高蛋白、高维生素饮食,鼓励患者新鲜蔬菜和水果的摄入。术前遵医嘱予完善各项辅助检查,根据情况予颈部及胸部备皮。

        3.术后护理

        3.1 病情观察 术后遵医嘱予吸氧、心电监护,严密观察生命体征的变化,观察患者有无呼吸困难,声音嘶哑、饮水呛咳,有无手足麻木、抽搐感,观察有无甲状腺危象,如有异常及时汇报医生对症处理。

        3.2 切口及引流管护理 切口应观察有无肿胀,周围皮肤有无渗血及青紫,定时挤捏引流管,保持其通畅有效引流,严密观察引流液的量、颜色和性质,如有出血或乳糜漏及时汇报对症治疗。

        3.3 体位及饮食指导 术后患者颈部应制动,以免过多活动引起出血,术后麻醉清醒、血压平稳后可改半卧位,以减少切口张力利于引流管通畅且利于呼吸顺畅。术后6小时后根据患者情况予进温凉半流质饮食,切忌过烫。进食时观察有无呛咳等不适。

        3.4 术后并发症的观察和护理 (1)呼吸困难和出血 是术后最危急的并发症,多发生于术后48小时内。按医嘱床边备气管切开包,立即配合床边抢救或进手术室,迅速去除血肿;若为喉头水肿者,嘱其不说话,遵医嘱使用激素。(2)喉返神经损伤 观察有无声音嘶哑或失音。应做好安慰解释工作,以减轻病人焦虑。 (3)喉上神经损伤 外支损伤可引起音调降低;内支损伤在进食或饮水时发生呛咳、误咽。发生呛咳,要协助病人坐起进食,或半流质饮食。(4)甲状旁腺损伤 出现口唇、四肢麻木、手足抽搐时,立即静脉注射10%葡萄糖酸钙。抽搐时,立即用压舌板或匙柄垫于上下磨牙间,以防咬伤舌头。限制含磷较高的食物,如牛奶、瘦肉、蛋黄、鱼类等。(5)乳糜漏 术后观察引流液情况,引流量突然增加,且由 变为乳白色,应怀疑淋巴漏的发生,及时报告医生进行引流液的化验,早期诊断治疗。遵医嘱予持续恒定的负压吸引,制约饮食,补充营养,应用奥曲肽等有效的医疗护理措施[3]。1例乳糜漏患者经积极治疗后完全治愈。

        甲状腺癌吧 天涯论坛

        手术室护理管理论文关于手术室的护理论文关于手术室护理的论文护理医学毕业论文护理医学论文范文护理教学论文

        3.5 出院健康指导 (1)教会患者自行检查颈部,出院后定期复诊。(2) 指导其练习颈部活动,推动颈部的功能恢复。颈淋巴结清扫术者在切口愈合后应开始肩关节和颈部的功能锻炼,预防肩下垂。功能锻炼应持续至出院后3个月。(3)帮助其调整心态,配合治疗。(4)对于甲状腺全切除者,应早期给予足量的甲状腺制剂,预防肿瘤复发。(5)术后忌碘饮食,勿食海鲜类食物。

        4.小结

        甲状腺癌的发病率在逐年升高,外科手术切除是改善其预后的最有效策略。由于甲状腺癌根治性手术创伤较大,因此护理工作在手术疗效和患者预后方面越来越重要,精心的护理是手术成功的重要保证。总之,从生理、心理、健康等各方面对患者进行综合护理,,能有效减轻病情,推动疾病的恢复。

        参考文献

        [1] 黄雪辉,黄梅连,吴秋莉. 甲状腺癌患者的围手术期护理[J]. 当代护士 2011,(1):6

        2

        参考材料:

        [1]甲状腺癌手术前后的护理体会

        [2]甲状腺癌手术前后临床护理

        权威点评

        甲状腺癌论文怎么写?本文关于甲状腺癌吧 天涯论坛论文范文,可以做为相关论文参考文献,与写作提纲思路参考,是术后和患者和手术开题报告范文,对相关文献综述及职称论文参考文献资料下载有帮助.

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