目的

探讨颅颌面巨大肿瘤联合切除术围手术期的护理经验。

方法

对2010 年3 月至2012 年2 月中山大学附属口腔医院收治的颅颌面巨大肿瘤切除术8 例进行全面分析，总结其围手术期护理经验、病情监测的重点及并发症的防治。

结果

本组8 例患者，其中1 例术中因大出血出现休克，经配合紧急输血及止血处理后顺利完成手术；1 例发生术后脑脊液耳漏，通过保守治疗及相关护理未并发颅内感染；1 例术后眶周局部创口回流障碍，及时发现并对症处理后肿胀缓解；1 例术后抽出鼻部填塞碘仿纱条后出现局部创口出血。 全部患者术后创口均Ⅰ期愈合，未出现颅内高压及呼吸道梗阻窒息等严重并发症，无手术相关死亡，均康复出院。

结论

颅颌面巨大肿瘤联合切除术涉及多学科领域需鼻咽喉-头颈外科、神经外科、眼科、口腔科、整形修复外科等多学科共同合作，其临床护理特点是多学科的综合护理。 充分的术前准备、密切的术中配合、严密的术后观察、及时有效的处理病情变化等全程细心的护理是手术成功的关键。

Objective

This paper aimed to summarize our experience of peri-operative care in resections of giant craniomaxillofacial tumors.

Methods

From March 2010 to February 2012，8 patients underwent craniomaxillofacial giant tumor resections in the Department of Oral and Maxillofacial Surgery，Hospital of Stomatology，Sun Yat-sen University. Peri-operative care and monitoring，as well as prevention and cure of complications in these cases were summarized.

Results

All wounds were healed primarily in these 8 cases. Post-operative cerebrospinal rhinorrhea happened in one patient.Wound bleeding was observed in one patient after pulling out the packed iodine gauze in wound cavity.All these complications were appropriately treated and all patients recovered and discharged with no severe complications.

Conclusions

Resection of craniomaxillofacial giant tumor is a team work with multidisciplinary cooperation，including E.N.T.-head and neck surgery，neurosurgery，ophthalmology，maxillofacial surgery and reconstructive surgery. Multidisciplinary comprehensive peri-operative care is also important. Sufficient pre-operative preparations，accurate cooperation in surgery，close post-operative observation，as well as timely and effective treatment，contribute to the success of surgery.