Nasal polyps are caused by long-term chronic inflammation of nasal mucosa or allergic swelling of nasal mucosa and sinuses, which leads to swelling, edema or hypertrophy of submucosal interstitial water, thus making the mucosa droop. It can occur in one or more nasal cavities on one side or both sides, and the enlargement of polyps will bring a lot of trouble and pain to patients. At present, the treatment of this disease is nasal polypectomy. This paper summarizes the nursing experience of 46 patients with nasal polyps treated in our department in recent two years before and after operation.
clinical data
There were 46 cases in this group, including 36 males and 36 females 10, all of which underwent polypectomy.
2 1 ~ 28 years old, with 20 cases of unilateral nasal polyps and 26 cases of bilateral nasal polyps. The symptoms of nasal congestion were relieved after operation and there was no recurrence in the past two years.
Nursing care before and after operation
Preoperative nursing
1. Do psychological care and warmly receive patients, and introduce the ward environment and doctors in charge in detail.
Nurses, and properly placed; Encourage patients to express their feelings and give specific guidance for the reasons; Encourage patients to talk with roommates, divert patients' attention and make them adapt to the environment as soon as possible; Patiently introduce the purpose of treatment and surgical methods to patients, introduce successful cases to patients, eliminate patients' anxiety caused by environmental changes, worry about surgical results and diseases, thus enhancing patients' confidence in surgical treatment and cooperating with treatment with a good attitude.
2. Routine preoperative examination comprehensively evaluates whether the patient's physique can tolerate the proposed operation. hand
Cut the nose hair the day before the operation. Don't damage the mucosa to prevent wound infection. No matter what kind of operation you do, you should explain clearly to the patient what its purpose is, so as not to cause unnecessary psychological pressure to the patient.
postoperative care
1. Liquid food and semi-liquid food with high calorie, high protein and rich vitamins should be given after eating.
To increase the body's resistance and prevent infection. Diet should be warm and not cold, so as not to cause wound bleeding due to overheating and excessive damage to mucosa.
2. Good posture plays a key role in postoperative recovery, such as taking a semi-recumbent position.
It can reduce head congestion and bleeding, facilitate secretion discharge and relieve local swelling. Proper exercise on the second day after operation is particularly important for relieving pain and enhancing physical resistance.
3. Ask the patient to gently spit out the secretions in the mouth, and it is not advisable to cough hard, let alone swallow.
Avoid causing stomach discomfort, leading to adverse reactions such as nausea and vomiting. Local cold compress was applied on the second day after operation to promote vasoconstriction, reduce bleeding and relieve pain and swelling. Let the patient drink a small amount of water several times to moisten the oropharynx, or cover the patient's mouth with wet gauze after operation to moisten the inhaled air.
4. Closely observe whether the nasal congestion is loose and prominent, and tell the patient not to take off the gauze.
Pull it out by hand and report it to the doctor in time. Patients with paroxysmal sneezing and coughing should be instructed to open their mouths and take a deep breath to avoid bleeding due to blockage.
5. Pain nursing guides patients to take a deep breath to relax muscles, or listen to music and read books.
Talk to patients and other methods to distract patients, and apply appropriate painkillers to relieve symptoms when necessary.
6. Close observation of the patient's vital signs, the correct application of antibiotics and hemostatic drugs, and pay attention to.
Observe whether there is bloody secretion in the nasal cavity and the color of oral secretion, stabilize the patient's mood and report to the doctor in time.
discuss
Nasal polypectomy is a general intranasal operation. Although it is minimally invasive, it is operated under local anesthesia.
Therefore, the pain and inconvenience during and after operation make patients feel great fear, which may seriously lead to complications such as incomplete operation or postoperative bleeding. Therefore, the nursing quality before and after operation plays an important role. The author believes that the focus of nursing should be how to relieve the psychological pressure of patients before operation, inform patients of the harm and prognosis of the disease through talks and popular science propaganda, and how to cooperate with rehabilitation nursing after operation. Care and care should be given to patients after operation, and problems should be solved in time. If there is any abnormal situation, you should take emergency measures immediately and report to the doctor. When you leave the hospital, you should introduce the precautions to the patients in detail, such as quitting smoking and drinking, avoiding irritating food, paying attention to the combination of work and rest, strengthening exercise, preventing colds, not blowing your nose and picking your nose, taking medicine on time, and coming to the hospital for follow-up regularly.