施丁丹

    【摘要】? 总结1例鼻咽癌放疗后合并第二原发舌癌行左舌根肿物扩大切除术患者，术后并发体位性呼吸困难的护理体会，以指导后续同类患者的临床护理工作。分析此病例发生体位性呼吸困难的原因，在找原因过程中，护士巧用便携式血氧饱和度仪，为患者的疾病发展争取到了关键的时间。归纳护理工作中症状观察的重点及护理实践中的难点。主要护理措是：关注患者舌根肿胀情况，持续便携式血氧饱和度监测，及时发现患者血氧饱和度下降，并分析原因；指导患者日常体位护理，睡眠时摇高床头30°～ 45°，保持侧卧位，避免平卧时舌后坠阻塞气道；心理护理，建立康复信心，解除睡眠恐惧，促进疾病恢复；控制体重，减少因体型偏胖、脖子粗短引起体位性喉梗阻的危险因素。本例患者住院12天，生命体征平稳，呼吸顺畅，情绪稳定，术区无肿胀，因舌体运动受限留置胃管出院。

    【关键词】? 舌癌；呼吸困难；原因分析；护理

    中图分类号? R766.3? ? 文献标识码? A? ? 文章编号? 1671-0223(2023)01--03

    Analysis of the causes of the postural dyspnea and nursing experience of one patient after carcinoma of tongue Shi Dingdan. The Department of Stomatology， The First Affiliated Hospital of Guangzhou Medical University， Guangzhou 511410， China

    【Abstract】? The nursing experience of a case of nasopharyngeal cancer after radiotherapy with the second primary tongue cancer， complicated by postural dyspnea， was summarized， so as to guide the subsequent clinical nursing work of similar patients. The cause of the positional dyspnea in this case was analyzed. In the process of finding the cause， the nurse skillfully used the portable blood oxygen saturation meter to get the key time for the development of the patient's disease. Summarize the key points of symptom observation in nursing work and the difficulties in nursing practice. The main nursing measures are： pay attention to tongue root swelling ......