ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会
重症护理研究

口腔颌面部间隙感染继发下行性坏死性纵隔炎患者的护理

  • 叶国凤 ,
  • 付梦琦
展开
  • 310000 杭州市 浙江大学医学院附属第二医院口腔颌面外科
叶国凤:女,本科,副主任护师,护士长,E-mail:yeguof@zju.edu.cn

收稿日期: 2023-03-23

  网络出版日期: 2023-08-17

Nursing of patients with descending necrotizing mediastinitis secondary to oral and maxillofacial space infection

  • YE Guofeng ,
  • FU Mengqi
Expand

Received date: 2023-03-23

  Online published: 2023-08-17

摘要

总结10例口腔颌面部间隙感染继发下行坏死性纵隔炎患者的护理经验。针对该组患者发生呼吸道梗阻、纵隔感染导致呼吸不畅、间隙感染术后置入不同引流装置的护理难点、术后严重并发症护理等问题,采取针对性气道管理,胸腔穿刺治疗后的管道管理,3种不同引流装置的个性化护理,重视患者主诉、动态评估患者术后并发症风险、及时判断并处理患者糖尿病酮症酸中毒、静脉血栓栓塞症及消化道出血等并发症。经积极对症治疗和护理,该组患者临床症状明显好转,住院第11~53天出院。

本文引用格式

叶国凤 , 付梦琦 . 口腔颌面部间隙感染继发下行性坏死性纵隔炎患者的护理[J]. 中华急危重症护理杂志, 2023 , 4(8) : 737 -740 . DOI: 10.3761/j.issn.2096-7446.2023.08.014

Abstract

The nursing experience of 10 cases of descending necrotizing mediastinitis secondary to oral and maxillofacial space infection was summarized. In terms of problems such as airway obstruction,mediastinal infection leading to dyspnea,postoperative placement of different drainage devices after interstitial infection,and postoperative serious complications in this group of patients,we adopted targeted airway management,postoperative pipeline management after thoracentesis treatment,personalized care of three different drainage devices and focused on patient complaints,implemented dynamic assessment of the risks of postoperative complications,timely judged and treated complications such as diabetic ketoacidosis,venous thromboembolism and gastrointestinal bleeding. After active treatment and nursing,the patients in this group improved significantly,and they were discharged from the hospital within 11 to 53 days.

参考文献

[1] 李云鹏,石冰,张浚睿,等. 口腔颌面部间隙感染诊疗专家共识[J]. 中华口腔医学杂志,2021,56(2):136-144.
Li YP,Shi B,Zhang JR,et al.Professional consensus on the treatment of oral and maxillofacial space infections[J]. Chin J Stomatol,2021,56(2):136-144.
[2] 郑宏雨,李紫璇,牛志兴,等. 口腔颌面部及颈部多间隙感染合并下行性坏死性纵隔炎多学科协作诊疗的回顾性分析[J]. 中华口腔医学杂志,2020,55(12):952-957.
Zhen HY,Li ZX,Niu ZX,et al.Retrospective analysis of the effectiveness of treating multi-space infection combined with descending necrotizing mediastinitis at oral maxillofacial and cervical region via multidisciplinary team collaboration[J]. Chin J Stomatol,2020,55(12):952-957.
[3] 郭治辰,萨肯德克·居马太,贾馨雨,等. 59例口腔颌面部多间隙感染继发下行坏死性纵隔炎的回顾性分析[J]. 口腔疾病防治,2021,29(2):94-98.
Guo ZC,Sakendeke JMT,Jia XY,et al.Retrospective analysis of 59 patients with descending necrotizing mediastinitis from oral and maxillofacial space infection[J]. J Prev Treat Stom Dis,2021,29(2):94-98.
[4] 叶国凤,于爽,付梦琦,等. 口底多间隙严重感染行气管切开术后并发大出血1例的急救及护理[J]. 护理与康复,2018,17(6):91-93.
Ye GF,Yu S,Fu MQ,et al.One case of emergency treatment and nursing of massive bleeding after tracheotomy for severe infection with multiple oral bottom spaces involvement[J]. J Nurs Rehabl,2018,17(6):91-93.
[5] 马婕,陈欢,李云鹏,等. 口腔颌面部间隙感染的管理(十)——围手术期的护理与观察[J]. 实用口腔医学杂志,2019,35(4):621-624.
Ma J,Chen H,Li YP,et al.Management of oral and maxil-lofacial space infections(part ten)-Nursing and observation during the perioperative period[J]. J Pr Stom,2019,35(4):621-624.
[6] Urakov A.Multifunctional irrigation-assisted vacuum drainage versus traditional drainage in the treatment of odontogenic deep fascial infection:a retrospective cohort study[J]. Infect Drug Resist,2021,14:3863-3864.
[7] 李云鹏,杨鹏,邢影,等. 颌面部间隙感染的管理(五):糖尿病患者伴发间隙感染诊治经验[J]. 实用口腔医学杂志,2018,34(5):717-720.
Li YP,Yang P,Xing Y,et al.Management of oral and maxi-llofacial space infections(part V)-Diagnosis and treatment ex-perience in cases of space infections in patients with diabetes[J]. J Pr Stom,2018,34(5):717-720.
[8] 陈莉明,陈伟,陈燕燕,等. 成人围手术期血糖监测专家共识[J]. 中国糖尿病杂志,2021,29(2):81-85.
Chen LM,Chen W,Chen YY,et al.Expert consensus on perio-perative blood glucose monitoring in adults[J]. Chin J Diabe-tes,2021,29(2):81-85.
[9] 孙沫逸,郭伟,冉炜,等. 口腔颌面外科围手术期静脉血栓栓塞症评估与预防专家共识[J]. 实用口腔医学杂志,2021,37(3):293-302.
Sun MY,Guo W,Ran W,et al.Expert consensus on assess-ment and prevention of perioperative venous thromboem-bolism in oral and maxillofacial surgery[J]. J Pr Stom,2021, 37(3):293-302.
[10] 柏愚,李延青,任旭李,等. 应激性溃疡防治专家建议(2018版)[J]. 中华医学杂志,2018,98(4):3392-3395.
Bai Y,Li YQ,Ren XL,et al.Expert recommendations for the prevention and treatment of stress ulcers(2018 edition)[J].Natl Med J China,2018,98(4):3392-3395.
文章导航

/

〈 〉