1.Operative field care: Patients with transcranial approach should observe whether the surgical site dressing is intact and whether there is any exudation; those with more exudation should promptly remind the doctor to change the medication; those with more hemorrhagic exudation should pay attention to monitoring the change of the patient’s blood pressure; all kinds of operations should be strictly aseptic and restrict visitation to avoid cross infection. Patients undergoing surgery through the pterygoid sinus should pay attention to the leakage of fluid in the nostrils bilaterally, and generally the nasal gauze can be removed both in 3 d after surgery. Attention should be paid to observe whether there is fluid leakage and to identify whether it is cerebrospinal fluid.
2, position: when not awake, take the pillow lying position, head to the side, timely removal of oral secretions to prevent accidental aspiration. If there is cerebrospinal fluid nasal leakage, take the position of lying on the pillow for 7~15 d. If there is no cerebrospinal fluid nasal leakage, elevate the head of the bed 15°~30° to facilitate breathing and reduce intracranial pressure.
3. Close observation: Closely observe the patient’s consciousness, pupils, vital signs and urine output. Keep the airway unobstructed, assess the patient’s degree of impaired consciousness in terms of patient’s language, eye opening and movement. Comatose patients should be cared for according to the nursing routine, do a good job of basic nursing care to ensure that there are no nursing complications, teach the chaperones to measure the urine volume for the patient, and nurses should accurately record 24h in and out.
4.Keep the respiratory tract unobstructed: After the operation, the patient will return to the ward with a tracheal tube, insert oxygen into it, adjust the oxygen flow to about 3~4L, remove oral secretions in time, as well as secretions in the tracheal tube, and maintain a clear respiratory tract.
5, hyperthermia care: according to the patient’s dietary habits to allocate a reasonable diet for patients, give high-calorie, high-protein, high-vitamin, low-fat easily digestible liquid or semi-liquid food, encourage patients to drink more water, the daily intake is not less than the 24h out. Those with body temperature above 39℃ are given physical cooling by ice bag, ice cap, cold compress; ethanol rubbing bath, ice water rubbing bath, warm water rubbing bath. When the patient is sweating a lot or fever reduction, attention should be paid to keep warm, observe whether there is deficiency, and keep the room air fresh.
6. Pain care: Pain is one of the common clinical symptoms of postoperative patients, and the cause, nature, degree and location of pain should be closely observed. To strengthen psychological care, nursing staff should first establish good feelings with patients, gain trust, stabilize patients’ emotions and eliminate their tension and fear.