关键词: 颅底, 放射性骨坏死, 吸入性肺炎, 脑脊液漏, 颅腔积气, 肿瘤护理

Abstract:

This study summarises the care provided in a case undergoing general anaesthesia for endoscopic transnasal skull base necrotic bone removal + composite tissue flap skull base reconstruction with sequential secondary aspiration pneumonia，fungemia，intracranial infection，cerebrospinal fluid leak，and air cranium. Key points of care：early swallowing assessment and perioperative ingestion management，the reduction of the risk of mis-aspiration，the rapid recovery of oral feeding；prone position ventilation in combination with vibratory drainage techniques of the infected lung lobes promoted purulent drainage and enhanced ventilation. The key to the care of a massive cerebrospinal fluid leak with pneumocephalus included proper placement of the patient based on the position of the leak，control of head and body movement，and monitoring of the volume of secretions on the tracheotomy bag. The position of the nasal cannula was observed，and nasal skin care was performed to ensure the position of the cannula and the integrity of the nasal skin. The patient was discharged after 45 days of hospitalisation with meticulous treatment and care.

Key words: Skull Base, Osteoradionecrosis, Aspiration Pneumonia, Cerebrospinal Fluid Leakage, Cranial Cavity Gas Accumulation, Oncologic Nursing