The carotid artery lump cuts off the nursing that the big concealed vein neck total artery builds a bridge Shu to realize

The carotid artery body lump is a kind of chemistry to feel machine tumor, the main occurrence is at the carotid artery body and take neck lump as main clinical performance, usually Be located on the neck total artery to cross a neighborhood, can oppress sympathetic nerves and the 9~12th Lu nerve, oesophagus and windpipe but cause Homer comprehensive advertise for, hoarse, the Qiang cough, stretch tongue to be partial to companion tongue the muscle atrophy, swallow or dyspnea etc. symptom, the surgical operation needs carotid artery excision and reconstruction, Shu behind easily cause to be partial to complicationses, such as Tan and Lu nerve harm...etc., the clinical nursing is more difficult.My section successfully saves to cure a carotid artery lump sufferer for the very first time in April, 2006 and realize a nursing now the report is as follows.
1.Clinical data
Sufferer, female, 25 years old, gradually increase a swollen thing of born nature for 3 years without the pain because of the neck, the companion pulsates 1 and half years, on March 29, 2006 income my section, have no external injury and surgical operation history.There is one 2.0 cm × 2.0 cms swollen thing in the check-up left neck after hospitalizing, the companion obviously pulsated, oppressed the neck total artery swollen thing to narrow and pulsated disappearance.MRI checks to share a sexually transmitted disease to change inside the left side neck sheath cleft and considers having a great possibility for the carotid artery body lump.Give the carotid artery oppression the training after hospitalizing, have no to obviously and badly respond after going to a 40 min.On March 9 at all numb under go left neck artery body lump resection, the big concealed vein neck total artery to take bridge Shu, the surgical operation is smooth.The Shu future trouble recovers good, have no cerebral ischemia to wait related complications.The pathologic report is a carotid artery body lump.Sufferer in April, 200626 sunrise hospitals, totally go to hospital for 26 days.
2.Before the Shu nursing
2.1 mental nursing sufferers are diagnosed for the carotid artery body lump after hospitalizing, because it doesn't have related paroxysm knowledge, the load scheme design is partial to Tan behind, again add a sufferer young and single, the wound influences his/her own beauty after the load scheme design, and the personality is introverted, the emotion is low to fall and don't talk very much, hence we toward it introduce my section abundant experience and technique real strenght, relate a successful case, Shu empress of head system dynamic importance, increase a sufferer to win paroxysm confidence and courage, actively match with a medical personnel to work well to prepare before the Shu and make it have an operation by the best mental appearance.
2.2 the carotid arteries oppress to train a purpose before the Shus is promote establishment Lu seamy side to pay circulation and avoid to need to be ligatured or cut off carotid artery in the Shu to the brain blood provide break off but make the brain injured and cause serious complications.Method:First touch with the showing of skill and middle finger the pathological changes together lateral Nie shallow artery pulsates, again use another skill in the lump body under the neck total artery to 6 cervical vertebras horizontal Tu direction oppression, with could not touch the Nie shallow artery pulsates for degree, and start accounting, observe inquiry the sufferer has have no dizzy, disgusted, vomit, confused, sight misty, the cerebral ischemia performance of body muscle dint decrease etc., if have above-mentioned performance, immediately stop oppressing, record to oppress keep on time, and guards in the bedside, until sufferer aware of self symptom disappearance.Oppressing the training can oppress time to vary from person to person each time 2~3 times every day, general since 3~5 min, prolong to gradually 30 mins.
2.3 work well before the Shu preparing of the whole hemp such as have skin, have the blood 800~1200 mls, prevent°from sex applied before the Shu antibiotic, protect a good pathological changes part, avoid being pressed and collide, keep lump body from blowout to lead to bad result, strengthen nourishment, the prevention catches a cold.
3.The nursing of Shu empress
3.1 sufferers are even to lie, the neck system moves and lies a bed for 5~7 days and as far as possible reduces a head activity and prevent°froms transplanting blood vessel distortion, the benefit fits together at the neck of heal, cut off a big concealed vein body to jack up 15 °s~30 °s, the benefit is at the vein reflux and closely observe skin color and temperature in the meantime and make sure have no the blood bolt formation.
3.2 Shu areas are infected of observation the close observation disease prevent°from issue of blood:(1)The color that the observation assists to anticipate and ooze amount of blood.(2)Keeping negative to press to lead to flow is lucid whether fixing is firm and prevent°from taking off, the 24 hs leads discharge>300 mls, the color is fresh and red, should watch out for the possibility of movable issue of blood.(3)Observe sufferer consciousness circumstance, keep blood pressure as usual and stability.(4)Reduce a sufferer's head activity, prevent°from transplanting afferent place blowout.(5)Prevent°from a cough and sneeze and be constipated.(6)Reduce a sufferer emotion motion.(7)The bed fully meets an emergency apparatus beside and useds for greatly bleeding a first aid.
Stop carotid artery in observation and nursing Shu of 3.3 Lu brain symptoms, make to be provided for the brain organization of blood to lack with the side artery inside the neck blood, if the tiny circulation inside sufferer Lu isn't perfect to die for the possible occurrence brain Geng, the surgical operation removes tumor if bleeding is more or the carotid artery rebuild to then even need to stop carotid artery, increased a cerebral ischemia.The nursing is operating process, should observe the life body advertises for and notice a sufferer state of mind variety and double side eye pupil whether waits great etc. circle, to light glint whether intelligent, sight whether faintness.Suffering from the side cerebral ischemia can cause to the side body and suffer from the side brain nerve function obstacle, the muscle tension and body activity circumstance of observation double side, having didn't be partial to Tan occurrence.
3.4 food instruction because of the pneumogastric nerves and the tongue in Shu swallow nerve is cut off, all appear different degree of voice hoarse and take a meal Qiang to cough, swallow a difficult phenomenon, the nursing personnel should patiently and delicately guide sufferer's practice to swallow and give out sound action, and guard by the side of the bed, give encouragement in good time, increment confidence, first from drink a little amount boiling start, practice to swallow action, gradual transition is enter liquid substance, half liquid substance.Be trained by instruction, 3~4 divas can enter liquid substance food, 10 divas can enter half liquid substance food.
3.5 functions toughens the ligation carotid artery easily take place blood to bolt, air cook, can cause to suffer from a side body to be partial to Tan and lose language, shoulding strengthen to suffer from a limb can toughen.As sufferer is lying a bed, the nursing personnel hands a sufferer to do on the bed passive exercise, the sufferer could exercise in the bedside while just descending ground and prevent°fromed strenuous exercises.
The nursing set tube that 3.6 windpipes cut open should disinfect on time and in fixed time order brine and prevent°from doing the formation of Jia, foundation nursing work well to turn over a body and massage, make the sufferer keep a good mindset, be advantageous to paroxysm to recover from illness.Apply to expand afferent medicine after the Shu, all tingle to cause stomach and intestines function to weaken and the Qiang cough to absorb quantity shortage, all and easily cause blood capacity opposite shortage or to the brain blood infuse to note quantity shortage.
Pass this sufferer's nursing, the writer thinks to should work well carotid artery oppression to experiment before the Shu, Shu behind should prevent°from infection complications in the Lu.
［ Reference ］
1.Huang Jian Nan, Chen Jie.The tumor merges the study of resection.Chinese ear nose throat Lu bottom surgery magazine, 1997, 3:(2)77-80.