华山医院对接受健侧颈7神经移位术的脑卒中患者的围手术期护理方案。
Huashan perioperative nursing program for stroke patients undergoing contralateral seventh cervical nerve transfer.
作者信息
Su Fan, Xu Ye, Wang Xiaoqian, Zhou Yiqun, Xu Wendong, Zhang Yaojin, Liu Ying
机构信息
Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, No. 259 Xikang Rd., Shanghai, 200040, China.
Department of Hand Surgery, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Rd., Shanghai, 200040, China.
出版信息
Perioper Med (Lond). 2022 Apr 7;11(1):12. doi: 10.1186/s13741-022-00245-4.
BACKGROUND
A previous investigation regarding contralateral seventh cervical nerve transfer (CC7) revealed a novel and effective approach to improve arm function in patients with chronic spastic paralysis. The patients who underwent both CC7 and standard rehabilitation showed greater functional improvements and spasticity reductions than patients in the control group, who underwent rehabilitation only. Additional efforts are needed to maximize the benefits in patients and establishing a supporting nursing program is a promising method for achieving this goal.
METHODS
The present Huashan nursing program was established in consideration of the following elements: providing routine perioperative care, ensuring surgical safety, and improving patient cooperation. Before surgery, psychiatric nursing, health education, and risk control were emphasized. After surgery, in addition to routine nursing and positioning, special attention was needed for targeted nursing in cases of postoperative adverse events. In addition, we performed descriptive statistical analysis of the clinical data of patients participating in the Huashan nursing program, focusing on postoperative adverse events. In total, 85 patients were included in the study, 10 of whom experienced adverse events, including severe pain (5, 5.88%), neck hematoma (2, 2.35%), dyspnea (2, 2.35%), and hoarseness (1, 1.18%). The above adverse events were alleviated through the targeted nursing care guided by the Huashan program.
DISCUSSION
This article introduces the Huashan nursing program, which is based on preoperative evaluations, educational sessions, postoperative monitoring, and targeted nursing, for patients undergoing CC7. This nursing program helped promote and provided the opportunity to maximize the benefits of CC7.
背景
先前一项关于对侧第七颈神经移位术（CC7）的研究揭示了一种改善慢性痉挛性瘫痪患者上肢功能的新颖且有效的方法。与仅接受康复治疗的对照组患者相比，接受CC7手术及标准康复治疗的患者功能改善更显著，痉挛程度减轻更明显。需要进一步努力以最大化患者受益，建立支持性护理方案是实现这一目标的一种有前景的方法。
方法
当前的华山护理方案是综合以下要素制定的：提供常规围手术期护理、确保手术安全以及提高患者配合度。术前着重进行心理护理、健康教育和风险控制。术后，除常规护理和体位护理外，对于术后不良事件需进行针对性护理。此外，我们对参与华山护理方案患者的临床数据进行了描述性统计分析，重点关注术后不良事件。该研究共纳入85例患者，其中10例出现不良事件，包括剧痛（5例，5.88%）、颈部血肿（2例，2.35%）、呼吸困难（2例，2.35%）和声音嘶哑（1例，1.18%）。上述不良事件通过华山护理方案指导下的针对性护理得以缓解。
讨论
本文介绍了华山护理方案，该方案基于术前评估、教育课程、术后监测和针对性护理，适用于接受CC7手术的患者。此护理方案有助于促进并提供机会以最大化CC7手术的益处。
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