肝移植术后患者口腔护理方法的探讨

目的探讨肝移植术后患者的口腔护理方法，有效预防口腔并发症。方法对11例肝移植术后患者，在气管插管拔除前、后及患者恢复期分别实施口腔冲洗、擦拭加含漱、刷牙加含漱的口腔护理方法。结果1例发生口腔霉菌感染，其余未发生感染及其他口腔并发症。结论肝移植术后在不同阶段根据患者的情况实施不同的口腔护理方法，可有效预防口腔并发症的发生。     

不同口腔护理方法对口腔并发症的干预作用

就不同的口腔护理方法对口腔并发症的干预作用进行综述。提出在口腔护理中应认真观察，分析口腔并发症的原因，选择有针对性的干预方法。     

肝移植术后患者口腔护理方法的探讨

目的探讨肝移植术后患者的口腔护理方法,有效预防口腔并发症。方法对11例肝移植术后患者,在气管插管拔除前、后及患者恢复期分别实施口腔冲洗、擦拭加含漱、刷牙加含漱的口腔护理方法。结果1例发生口腔霉菌感染,其余未发生感染及其他口腔并发症。结论肝移植术后在不同阶段根据患者的情况实施不同的口腔护理方法,可有效预防口腔并发症的发生。     

3％碳酸氢钠联合制霉菌素甘油及碘甘油预防肝移植术后口腔并发症及肺部感染

目的探讨3％碳酸氢钠液漱口联合制霉菌素甘油及碘甘油进行口腔护理预防肝移植术后口腔并发症及肺部感染的效果。方法将166例肝移植术后患者随机分为对照组（79例）和观察组（87例）,对照组按常规采用生理盐水进行口腔护理，观察组采用3％碳酸氢钠液漱口联合制霉茼素甘油和碘甘油进行口腔护理,观察并记录术后肺部感染和口腔并发症的发生情况。结果观察组口腔并发症及肺部感染发生率显著低于对照组（均P〈：0．01）。结论3%碳酸氢钠液漱口联合制霉菌素甘油和碘甘油进行口腔护理对降低肝移植术后口腔并发症及肺部感染起看非常重要的作用。     

肾移植术后预防肺部感染的护理

在肾移植患者的死亡原因中，感染居首位。肺部感染是肾移植术后各种感染中发病率最高的并发症，而且具有病情重、发展快、临床治疗困难的特点。因此，应高度重视其预防。如何有效预防肾移植术后肺部感染就成为了护理的重点之一。     

综合性口腔护理预防系统性红斑狼疮患者口腔感染

目的探讨综合性口腔护理预防系统性红斑狼疮（SLE）患者口腔感染的效果。方法将129例SLE患者按入院顺序分为对照组（64例）和实验组（65例），对照组采用常规口腔护理方法，实验组根据患者口腔pH值及局部培养结果选择口腔护理溶液及局部应用抗生素，观察两组患者口腔pH值、口腔感染发生率。结果实验组发生口腔感染14例（21．54％），对照组为28例（43．75％），两组比较，差异有统计学意义（P＜O．01）；实验组真菌感染发生率显著低于对照组（P＜0．05）；实验组患者从入院第7天开始口腔pH值趋于碱性（6．90土1．35），第10天显著高于对照组（P＜0．01）。结论综合性口腔护理干预能有效提高SLE患者口腔pH值，减少和预防口腔感染尤其是真菌感染的发生。     

口腔擦洗结合牙龈按摩预防脑卒中患者肺部感染和口腔异味

目的探讨口腔擦洗结合牙龈按摩预防脑卒中患者肺部感染及去除口腔异味的作用。方法将200例脑卒中患者随机分为两组各100例。对照组使用湿棉球行常规口腔护理,观察组使用湿纱布擦洗并给予牙龈按摩。结果观察组肺部感染率及1级以上口腔异味发生率显著低于对照组(P<0.05,P<0.01)。结论口腔擦洗结合牙龈按摩可以减少脑卒中患者肺部感染和口腔异味的发生率。     

综合性口腔护理预防系统性红斑狼疮患者口腔感染

目的 探讨综合性口腔护理预防系统性红斑狼疮(SLE)患者口腔感染的效果.方法 将129例SLE患者按入院顺序分为对照组(64例)和实验组(65例),对照组采用常规口腔护理方法,实验组根据患者口腔pH值及局部培养结果选择口腔护理溶液及局部应用抗生素,观察两组患者口腔pH值、口腔感染发生率.结果 实验组发生口腔感染14例(21.54%),对照组为28例(43.75%),两组比较.差异有统计学意义(P＜0.01);实验组真茵感染发生率显著低于对照组(P＜0.05);实验组患者从入院第7天开始口腔pH值趋于碱性(6.90±1.35),第10天显著高于对照组(P＜0.01).结论 综合性口腔护理干预能有效提高SLE患者口腔pH值,减少和预防口腔感染尤其是真菌感染的发生.     

系统性红斑狼疮并发肺部感染的口腔相关因素及护理研究进展

系统性红斑狼疮患者由于免疫功能下降、口腔环境发生变化等原因,容易并发肺部感染。做好口腔护理,选择适当的口腔护理用药,密切观察病情变化可防范肺部感染发生。     

综合性口腔护理预防130例肿瘤化疗患者口腔感染观察

目的 探讨综合性口腔护理预防肿瘤化疗患者口腔感染的效果.方法 将130例肿瘤化疗患者按入院顺序分 为对照组和观察组各65例.对照组采用常规口腔护理,观察组根据患者口腔pH值及局部培养结果选择口腔护理溶液及局部运用抗生素.观察2组患者口腔pH值及口腔感染发生率.结果 观察组发生口腔感染9例(13.85%),对照组14例(...     

镶嵌治疗肌部多发室间隔缺损患儿的术后护理

目的 介绍镶嵌治疗肌部多发室间隔缺损后护理经验,以期提高术后护理质量,减少术后并发症,提高手术成功率.方法 对22例肌部多发性室间隔缺损患儿予以镶嵌和封堵治疗.结果 22例手术均成功,安返监护室,因多脏器功能衰竭死亡1例(4.5%).21例术后随访6个月至3年,14例患儿无明显影响心功能的残余分流,7例封堵器边缘残留少量左向右分流,但全组心功能基本正常.结论 保持呼吸通畅,心率、血压稳定,做好胸腔引流、心内测压管、体温的监测,加强特殊用药伊诺前列素的监护,密切监测中枢神经系统症状等是镶嵌治疗肌部多发性缺损术后护理的重点.     

混合痔患者术后的中医综合护理

目的 探讨中医综合护理干预应用于混合痔术后患者的康复效果。方法 将152例混合痔患者随机分为两组各76例。对照组实施常规护理;观察组在此基础上实施辨证论治、疼痛管理、辨证施膳、情志调护等中医综合护理干预。结果 观察组术后12 h、24 h、72 h疼痛评分,术后首次排便时肛门疼痛评分及术后5 d、14 d创面水肿评分显著低于对照组,术后1 d、3 d焦虑评分显著低于对照组(均P<0.05)。结论 混合痔术后患者实施中医综合护理干预,有利于降低并发症,缓解焦虑情绪,促进患者术后康复。     

脑包虫病患者的术后观察与护理

目的 探讨脑包虫病患者术后的观察与护理方法.方法 对37例脑包虫病患者行手术治疗,术后给予密切病情观察及护理.结果 37例患者手术均成功,无1例出现并发症,均痊愈出院.随访6个月至4年,无复发.结论 术后密切观察患者的病情变化,做好伤口与引流管、并发症以及用药观察与护理及出院指导,是减少术后并发症,提高手术成功率,促进患者早日康复的关键.     

低强度激光联合口腔护理用于急性白血病化疗后口腔黏膜炎

目的探讨低强度激光联合口腔护理用于急性白血病化疗后口腔黏膜炎的方法及效果。方法将63例急性白血病化疗后口腔黏膜炎患者随机分为两组。对照组(31例)按照传统方法口腔含漱治疗;观察组(32例)在此基础上应用低强度激光疗法治疗。结果两组治疗后口腔黏膜炎分级及愈合时间比较,差异有统计学意义(P<0.05,P<0.01)。结论低强度激光疗法对急性白血病化疗后口腔黏膜炎治疗效果优于传统方法。     

Rim mandibulectomy for cancer of the oral cavity

Improvements in our understanding of the methods of mandibular invasion by malignancies and refinements in the biomechanical analysis of mandibular osteotomies led us to modify our standard operative procedure for this disease process. Over a 10 year period, we performed rim mandibulectomy to treat oral cavity malignancies with mandibular involvement. This retrospective analysis of 38 patients comparing rim mandibulectomy with the traditional segmental mandibulectomy has demonstrated equivalent local control rates between rim mandibulectomy and segmental resection (75 and 64 percent, respectively). Patients with rim mandibulectomies were more satisfied with their postoperative appearance, and some were able to wear lower dentures if well motivated. In performing the rim mandibulectomy, we found that smooth, curved osteotomies without step-offs resulted in a technically simple operation that was biomechanically sound and had a low complication rate. Rim mandibulectomy, because it is based on sound pathologic principles and does not disrupt the mandibular arch, is an operation that adequately resects the tumor without compromising the cancer operation or the patient.     

Sleep apnea in patients with oral cavity and oropharyngeal cancer after surgery and chemoradiation therapy

Objective

To determine the point prevalence of sleep apnea in patients following oral and oropharyngeal cancer treatment at a major tertiary care referral center.

Study Design

A retrospective cross-sectional survey.

Subjects and Methods

Twenty-four patients with established oral or oropharyngeal cancer were submitted to overnight polysomnography. The surgical group consisted of 15 patients (11 male, 4 female; average age 64.2 yrs) having undergone primary surgery with radial forearm free flap reconstruction. The remaining patients (5 male, 4 female; average age 54.8 yrs) were treated nonsurgically with chemoradiation therapy. The fatigue-related daytime sleepiness was measured with the Epworth sleepiness scale (ESS).

Results

Eleven patients in the surgical group and three in the nonsurgical group had a respiratory disturbance index (RDI) greater than 15 (odds ratio = 5.5, P = 0.092). Twelve patients in the surgical group and five in the nonsurgical group had significant oxygen desaturation during sleep hours (odds ratio = 3.3, P = 0.356). There was no observed significant correlation between RDI and oxygen desaturation (r² = 0.28), nor was there any observed association between the RDI and ESS score (r² = 0.18).

Conclusion

This preliminary study has suggested that surgical patients in our cohort have a higher prevalence of moderate to severe obstructive sleep apnea in the postoperative period, when tested, compared with a nonsurgical group. A small sample size and incomplete matching on important cofactors of interest, such as primary site location, body mass index, and thyroid function, limit this study. A pretreatment and post-treatment analysis is obviously required to demonstrate any significant level of association between treatment type and sleep apnea status.