CAJ | 학술논문

目的：对新辅助放化疗食管癌患者围手术期呼吸道的并发症及预防措施进行总结，并针对并发症提出相应的护理对策，为降低围手术期的并发症提供指导依据。方法选择该院2012年2月—2014年1月收治的92例ⅢA/ⅢB期食管癌患者，随机均分为实验组和对照组，实验组采用综合护理干预，对照组采用胸外科常规护理，术前均给予2～4周期的放、化疗，3～4周后根据肿瘤的生长情况选择不同的手术方式，并对围手术期呼吸道并发症的观察及所采取的护理对策进行总结。结果实验组围手术期发生医院感染11例，其中呼吸道感染3例，占医院感染的27.27%，对照组围手术期发生医院感染21例，其中呼吸道感染14例，占医院感染的66.67%。实验组医院感染率及呼吸道感染率明显低于对照组，差异有统计学意义（P<0.05）。结论新辅助放化疗患者围手术期医院感染以呼吸道感染最多，采取综合护理干预后，围手术期的医院感染率及呼吸道感染率明显降低，对促使患者的康复及提高患者术后的生存质量具有重大意义。
목적：대신보조방화료식관암환자위수술기호흡도적병발증급예방조시진행총결，병침대병발증제출상응적호리대책，위강저위수술기적병발증제공지도의거。방법선택해원2012년2월—2014년1월수치적92례ⅢA/ⅢB기식관암환자，수궤균분위실험조화대조조，실험조채용종합호리간예，대조조채용흉외과상규호리，술전균급여2～4주기적방、화료，3～4주후근거종류적생장정황선택불동적수술방식，병대위수술기호흡도병발증적관찰급소채취적호리대책진행총결。결과실험조위수술기발생의원감염11례，기중호흡도감염3례，점의원감염적27.27%，대조조위수술기발생의원감염21례，기중호흡도감염14례，점의원감염적66.67%。실험조의원감염솔급호흡도감염솔명현저우대조조，차이유통계학의의（P<0.05）。결론신보조방화료환자위수술기의원감염이호흡도감염최다，채취종합호리간예후，위수술기적의원감염솔급호흡도감염솔명현강저，대촉사환자적강복급제고환자술후적생존질량구유중대의의。
Objective To summarize the respiratory complications of patients with esophageal cancer after neoadjuvant chemoradio-therapy in the perioperative period and preventive measures, and put forward corresponding nursing strategies for the complications so as to provide guidance for reducing the complications during the perioperative period. Methods 92 cases with ⅢA/ⅢB esophageal cancer admitted in our hospital from February 2012 to January 2014 were randomly divided into experimental group and control group. The experimental group used the comprehensive nursing intervention. The control group used thoracic routine nursing. Both groups were given 2~4 cycles of chemotherapy and radiotherapy preoperatively and different ways of operation ac-cording to the tumor growth pattern 3~4 weeks later. And the observation of the respiratory complications occurred in the patients during the perioperative period and the nursing countermeasures that were taken were summarized. Results During the periopera-tive period, nosocomial infection occurred in 11 cases in the experimental group, including 3 cases of respiratory tract infection, accounting for 27.27% of hospital infection. Nosocomial infection occurred in 21 cases in the control group, including 14 cases of respiratory tract infection, accounting for 66.67%of hospital infection. The rate of nosocomial infection and respiratory tract infec-tion of the experimental group was significantly lower than that of the control group, the difference was statistically significant ( P<0.05). Conclusion Respiratory tract infections are the most among the hospital infections occurred in the patients with neoadjuvant chemoradiotherapy during the perioperative period. After the comprehensive nursing intervention, the rate of nosocomial infection and respiratory tract infection in the perioperative period is reduced significantly, which is of great significance in promoting the rehabilitation of the patients and improvement of the life quality of the patients.