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Objective:To summarize the case management of promoting the rehabilitation of oral and maxillofacial function of a patient with gingival cancer.Methods:The patient took the obturator prosthesis and orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function. The key points of nursing included: nursing of obturator prosthesis, orofacial myofunctional therapy, psychological nursing and evaluation of oral and maxillofacial function rehabilitation.Results:after one year of case management, the total score of the Chinese version of the obturator functioning scale was 18 points, the mouth opening was 4cm, and the speech distinctness was 98%. The quality of life of the patient was good.Conclusions:When the obturator prosthesis and orofacial myofunctional therapy are taken, all-round cooperation of the medical staff of different specialties from the perioperative period to the discharge follow-up should be strengthened in order to promote the rehabilitation of oral and maxillofacial function.
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Objective:To sum up nursing experience of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base.Methods:One patient with multi-drug resistant was admitted to our hospital in October, 2019. To observe and prevent the postoperative complications of lateral skull base and to prevent the rupture bleeding of carotid artery. The early detection and treatment the symptoms of upper gastrointestinal bleeding is effective and necessary. Intervention for patient receiving nutrition therapy is promoted.Results:By giving psychological care to improve patient compliance. The patient had no postoperative complications of lateral skull base, and the bleeding symptoms of upper gastrointestinal hemorrhage was controlled in time.Conclusion:The patient was discharged from the hospital with a tracheal tube in a stable condition.
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Objective:To observe the effect of personalized nutritional support on postoperative rehabilitation and nutritional status in patients undergoing radical mastectomy and reconstruction of oral malignant tumor.Methods:Eighty-eight patients with oral malignant tumor admitted from January 2018 to December 2018 in Hospital of Stomatology, Sun Yat-sen University were divided into two groups according to the time of admission. 40 patients were selected as the study group and 48 patients were selected as the routine group. The routine group was given traditional health education and dietary guidance. In addition to dietary guidance, the study group was given personalized nutritional support according to the patients' body mass index and nutritional status before and after operation, including oral nutritional supplement before operation, personalized nutritional prescription after operation, and increased protein intake according to the nutritional indicators of the patients. The nutritional status, enteral nutrition complications and postoperative rehabilitation were compared between the two groups two weeks after operation.Results:Two weeks after operation, the hemoglobin, total protein, prealbumin were (107.93±16.19) g/L, (68.40±4.87) g/L, (189.02±55.19) mg/L in the study group, and (101.23±14.62) g/L, (63.11±6.42) g/L, (165.75±40.60) mg/L in the routine group, there were significant differences ( t values were -2.037, -4.271, -2.276, all P<0.05). The incidence of malnutrition, wound infection and gastrointestinal complications were 42.50%(17/40), 0, 5.00%(2/40) in the study group and 64.58%(31/48), 16.67%(8/48), 20.83%(10/48) in the control group, there were significant differences( χ2 values were 4.292, 7.333, 4.644, P<0.05). Conclusions:Perioperative personalized nutritional support can effectively improve the nutritional status, reduce enteral nutrition-related complications, improve immunity and reduce the risk of incision infection in patients undergoing radical mastectomy and simultaneous reconstruction of oral malignant tumors, which is helpful to improve the quality of life of patients and is worthy of clinical reference.
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Objective:To understand the fever rate, disease distribution, fever degree and fever related factors of the patients in the same period of oral and maxillofacial tumor repair and reconstruction.Method:A retrospective analysis was performed on 153 patients who underwent radical treatment of oral and maxillofacial tumors from January 2018 to December 2018 in the affiliated stomatological hospital of sun yat-sen university. The patients were divided into fever group and non fever group, and their fever influencing factors were analyzed.Result:Among the 153 patients, 97 (63.40%) had fever symptoms.It’s mainly moderate fever. The incidence of fever was the highest in gingival cancer and oropharyngeal cancer.The results of univariate analysis showed that there were statistically significant differences in serum albumin, tracheotomy and infection between the two groups ( χ2= 7.74, 7.48, 8.58, P<0.01 or 0.05).Logistic multivariate regression analysis showed that infection and tracheotomy were independent influencing factors for postoperative fever in patients with oral and maxillofacial tumor repair and reconstruction (or = 4.74, 2.47, P < 0.05). Conclusion:Patients with oral and maxillofacial tumors undergoing radical treatment and simultaneous repair and reconstruction are more likely to have fever after surgery. Tracheotomy patients and patients with infection need to be paid more attention. They need to be strengthened tracheotomy care and actively prevent infection, so as to reduce the postoperative fever rate, and make the patients with oral malignant tumors repaired and reconstructed at the same time go through the perioperative period smoothly.
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Objective:To design and evaluate a new type of clothes for patients with reconstruction after oral cancer resection.Methods:According to the characteristics of patients after oral tumor resection and reconstruction, a new type of patient clothing was designed. From January 2018 to June 2018, 79 patients with oral malignant tumor radical resection combined with reconstruction were selected as the control group, using traditional patient clothing. 64 patients with the same operation were selected as the experimental group from July 2018 to December 2018, and the new patient clothing was used. The time of changing clothing, wearing comfort and privacy protection, the convenience for medical staff to observe and change wound dressing were to evaluate.Results:The clothing change time of the patients was (124.00±23.35) s in the experimental group, and (156.09±25.66) s in the control group,the difference was statistically significant( t value was 14.97, P<0.01). The scores of clothing comfort and privacy protection were 8.23±0.91, 7.17±0.94 in the experimental group, and 4.78±0.94, 5.50±0.89 in the control group, the difference were statistically significant( t values were -15.21, -9.95, P<0.01). The scores of medical staff observing wounds and changing wound dressings were 7.88±0.89, 7.87±0.83 in the experimental group, and 4.15±0.78, 4.15±0.78 in the control group, the difference was statistically significant( t values were -18.98, -17.75, P<0.01). Conclusions:The new clothes is effective for patients with reconstruction after oral cancer resection. It can be popularized in patients with oral cancer resection and reconstruction.
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Objective@#To evaluate the effect of a new kind of nasogastric feeding registration form based on energy intake in perioperative nutrition support for patients with oral cancer.@*Methods@#According to the specification of nasal feeding and summarizing the ingredients in common foods, the form was optimized and applied. By the cluster sampling method, the knowledge about energy intake of 12 nurses were investigated before and after the use of the form. The accuracy of energy intake assessment of 5 patients by 12 nurses respectively and the time required for single registration was compared before and after the use. Meanwhile, the knowledge about nasal feeding of 18 patients before the use and 17 patients after the use was compared.@*Results@#The mean score of knowledge about energy intake of nurses was 57.50±17.77 before the use, which was lower than that after the use (89.00 ±6.18), the accuracy rate before the use (61.67%, 37/60) was lower than that after the use (93.33%, 56/60), and the mean time was (18.16 ±6.26) s, which was longer than that after the use (12.65 ±5.67) s (t=17.317, χ2=17.252 and t=22.445 respectively, all P<0.01). The mean score of knowledge about nasal feeding before the use (69.44 ±15.89) was lower than that after the use (86.47±11.15)(t=-3.649, P=0.001). All difference showed statistical significance.@*Conclusion@#The nasal feeding registration form based on energy intake is clear and easy to fill out. It can not only help the medical staff calculate the energy intake of patients more accurately, but also help formulate nutritional intervention plan and promote the recovery of patients. Meanwhlie, It shortens the writing time and improves the effect of education. In conclusion, it is worth being popularized.