目的:总结喉返神经修复重建术围手术期的护理配合。方法:我科2007年10~11月手术治疗双侧喉返神经麻痹患者3例,手术前加强患者的心理护理、密切观察病情变化,及时处理声带麻痹引起的喉梗阻、误吸、呛咳等症状。术后重视体位护理、呼吸道的管理、保证药物及时准确使用,协助患者进行正确的吞咽进食训练、声带协调运动训练等康复护理。结果:3例患者术后均获完整随访,3月后均顺利拔除气管套管,无吸气性呼吸困难,无发音困难,嗓音质量较术前明显改善。结论:良好的围手术期护理有助于手术的成功。
目的:比较常规鼻胃管置入法与鼻咽部局部喷雾麻醉后置胃管法对喉癌患者的影响。方法:将需要安置胃管的100例患者随机分成两组,每组50例。实验组行鼻咽部喷雾麻醉,对照组按常规操作,比较两组患者流泪、恶心、呕吐、咳嗽反应,一次成功率及插管所需要时间、插入中暂停次数。结果:实验组一次成功率高,患者反应轻,插管所需时间有显著差异。结论:常规置胃管常因病员难受而中途暂停置管,实验组置胃管前先作鼻咽部局部喷雾麻醉,可明显减轻患者的痛苦,提高插胃管的一次成功率,插管过程中因病员难受暂停次数也明显减少,使临床护理工作时间缩短,对临床护理工作有积极意义。
Objective To investigate the current status of fear of disease progression and sleep quality among laryngeal cancer patients, and analyze the correlation between them. Methods Laryngeal cancer patients who were hospitalized in West China Hospital of Sichuan University between March 2021 and February 2022 were selected for this cross-sectional survey. Sociodemographic and disease-related data questionnaires, Chinese version of Fear of Progression Questionaire Short Form, and Pittsburgh Sleep Quality Index (PSQI) Scale were used to investigate the laryngeal cancer patients who met the inclusion criteria, and the correlation between fear of disease progression and PSQI score in laryngeal cancer patients was analyzed by Spearman correlation analysis. Multiple linear stepwise regression analysis was used to analyze the effects of sociodemographic and disease-related characteristics on the total score of fear of disease progression in laryngeal cancer patients, and the effects of sociodemographic, disease-related characteristics and total score of fear of disease progression on the total score of PSQI of laryngeal cancer patients. Scores were expressed as median (lower quartile, upper quartile). Results A total of 312 copies of questionnaires were distributed and 309 valid copies were recovered, with an effective recovery rate of 99.0%. The total score of fear of disease progression in the laryngeal cancer patients was 22.00 (16.00, 30.00), including 12.00 (8.00, 17.00) in physiological health dimension, and 10.00 (7.00, 14.00) in social and family dimension. The total score of PSQI was 5.00 (3.00, 8.50). The correlations of the physiological health dimension score, the social and family dimension score, and the total score of fear of disease progression with the total score of PSQI in laryngeal cancer patients were positive with statistical significance (rs=0.294, P<0.001; rs=0.234, P<0.001; rs=0.287, P<0.001). Multiple linear stepwise regression analyses showed that the total score of fear of disease progression in laryngeal cancer patients was affected by the stage of disease, occupation, primary caregiver and treatment plan (P<0.05), and the total score of PSQI of laryngeal cancer patients was affected by level of education, treatment plan and the total score of fear of disease progression (P<0.05). Conclusions The fear of disease progression in laryngeal cancer patients has a significant negative correlation with the sleep quality. Meanwhile, alleviating the level of fear of disease progression may improve sleep quality.