Nursing practice of a case of neck malignant lymphoma complicated wound
一例颈部恶性淋巴瘤疑难伤口的护理实践

摘要

目的 总结和探讨一例大B细胞、弥漫性免疫母细胞性恶性淋巴瘤导致的右侧咽颈部疑难伤口的护理方法。方法 使用循证护理理论、选取适合的伤口评估工具、科学分析，逐步循证实践、辨析伤口组织类型、医护患共同参与护理淋巴瘤破溃的疑难伤口。同时联合一系列的综合护理措施、包括心理情绪护理、居家护理、伤口卫生处置、营养支持等，改变淋巴瘤伤口进程、减轻伤口恶臭、预防伤口出血、树立患者治疗的信念，为患者下一步的放化疗提供伤口基底的治疗准备。结果 经过40天的伤口护理实践，该患者的GROCOTT恶性肿瘤气味等级评估由入门诊时的0级改善为2级；伤口肉芽组织创面0% 到40%；结论 此例疑难伤口护理的病例探讨与总结，有助于为今后临床再次处理同类型的淋巴瘤伤口积累护理实践经验，运用循证护理方法，在规范的基础上不断改进伤口处置方法，减轻患者痛苦，优化临床治疗。

Abstract

Objective To summarize and explore the nursing methods of a case of difficult wound of right pharynx and neck caused by large B cell and diffuse immunoblastic malignant lymphoma.
Methods: using evidence-based nursing theory, selecting appropriate wound assessment tools, scientific analysis, and gradually evidence-based practice, differentiating wound tissue types, and nursing care for difficult wounds with lymphoma. At the same time, a series of comprehensive nursing measures, including psychological and emotional care, home care, wound sanitary treatment, nutritional support, etc., are combined to change the process of lymphoma wound, reduce the odor of wound, prevent wound bleeding, establish the patient's belief in treatment, and provide the patient with wound base treatment preparation for the next step of radiotherapy and chemotherapy.
Results: after 40 days of wound nursing practice, the patient's odor grade of malignant tumor was improved from grade 0 at the initial diagnosis to grade 2; Wound granulation tissue wound 0% to 40%;
Conclusion  : the discussion and summary of this case of difficult wound care will help to accumulate nursing practice experience for treating the same type of lymphoma wound again in the future, apply evidence-based nursing methods, continuously improve wound treatment methods on the basis of standardization, reduce patient pain, and optimize clinical treatment.