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郭琦.高位食管癌食管-气管瘘内镜下封堵术的临床护理[J].上海护理,2017,17(3):
高位食管癌食管-气管瘘内镜下封堵术的临床护理
DOI：
中文关键词:  高位食管气管瘘 金属支架封堵术 临床护理要点
英文关键词:High esophageal tracheal fistula  Metallic stent placement  Clinical nurse keypoints
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作者单位E-mail
郭琦* 上海市徐汇区中心医院 13916321567@139.com 
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中文摘要:
      【】目的：探讨高位食管癌,食管-气管瘘内镜下全覆膜金属支架置入封堵术的临床护理要点。方法：对25例高位食管癌食管-气管瘘的临床护理资料,进行了回顾性的分析。结果：25例内镜下全覆膜金属支架封堵术均获成功(手术成功率100%)。术中无出血、穿孔等严重并发症。支架置入封堵术后患者进食呛咳、吞咽困难症状迅速缓解,肺部感染有了明显好转,术后并发症发生率12%(3/25),其中2例为严重胸痛,经口服止痛药物缓解。1例支架移位,内镜下应用异物钳对支架进行了调整。结论：全覆膜食管金属支架置入封堵术治疗高位食管癌食管-气管瘘,不仅可立即缓解患者吞咽困难,而且患者耐受度高。术中良好的护理配合,严密的病情观察,有利于支架顺利置入封堵。术前术后护理干预,可减少术后并发症发生率,对术后并发症快速恢复,及时阻止并发症的继续恶化,有效控制肺部感染,改善患者生活质量,具有十分重要的意义。
英文摘要:
      Objectiv Discuss clinical nurse key points for upper esophageal carcinoma with esophageal-tracheal fistula patients after fully-covered metallic stent placement by endoscopy. Methods Retrospectively analysis clinical nursing data of 25 upper esophageal carcinoma and esophageal-tracheal fistula cases.Results All of 25 cases(fully-covered metallic stent placement by endoscopy) were successful(25/25,100%). No bleeding or perforation happened during the operation. After operation, irritating cough and dysphagia were soon relieved, and pulmonary Infection had significantly improved. The postoperative complications incidence is 12%(3/25). Two cases were severe chest pain,relieved by anodyne. One case was stent migration, adjust by foreign forceps. Conclusions Fully-covered metallic stent placement for upper esophageal carcinoma with esophageal-tracheal fistula patients can relieve dysphagia immediately dysphagia and brought good patient tolerance. Good nursing cooperation among the operation and careful condition observation are good to the stent placement. Preoperative and postoperative nursing intervention can reduce the incidence of postoperative complications. It is vital to complications’ rapid recovery, to prevent complications worsen timely and provide effective control of lung infection and a better life quality.
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主管单位：上海市卫生健康委员会   主办单位：上海市护理学会  出版：《上海护理》编辑部
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