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通过对接受下肢肿瘤假体患者的护理来应对术后挑战。

Postoperative challenges addressed through nursing care of patients receiving lower extremity tumor prosthesis.

作者信息

Golemac Marina, Yilmaz Müjgan, Petersen Michael Mørk

机构信息

Rigshospitalet, Department of Orthopedic Surgery, University of Copenhagen, Inge Lehmanns Vej 6, 2100, Copenhagen, 35450640, Denmark.

出版信息

BMC Nurs. 2024 Oct 4;23(1):714. doi: 10.1186/s12912-024-02400-2.

Abstract

BACKGROUND

Patients with primary Bone Sarcoma and Giant Cell Tumors in the lower extremities often require major surgery involving tumor prostheses. The postoperative course for this patient group can be complex and influenced by various factors and challenges that demand careful nursing care. This study aims to identify challenges related to the nursing care of individuals with primary bone tumors following surgery for tumor prostheses in the lower extremities.

METHODS

A retrospective cohort study of 15 patients treated at Rigshospitalet, Copenhagen, Denmark, between November 5. 2016, and April 1. 2020 was conducted by medical record review, focusing on challenges related to postoperative nursing care. All patients with the surgery code "Bone Excision" were identified within the surgery booking system and screened for eligibility.

RESULTS

Patients experienced postoperative challenges such as severe pain, prolonged time to mobilization (mean: 4 days), and defecation (mean: 5 days). The mean length of stay at the Rigshospitalet was 13 days. Furthermore, eleven patients (73%) reported disrupted sleep and nausea.

CONCLUSION

Patients undergoing tumor prosthesis surgery in the lower extremities face considerable postoperative challenges that contribute to a prolonged hospital stay. These challenges, including severe pain, delayed mobilization, and gastrointestinal issues, significantly impact recovery. The findings highlight the urgent need for targeted nursing interventions to address these issues effectively. Enhanced pain management protocols, early mobilization strategies, and comprehensive postoperative care plans are essential to improve patient outcomes and reduce the length of hospital stays. Addressing these challenges through dedicated nursing care is crucial for optimizing the recovery process for patients receiving lower extremity tumor prostheses.

摘要

背景

原发性骨肉瘤和下肢骨巨细胞瘤患者通常需要进行涉及肿瘤假体的大型手术。该患者群体的术后病程可能较为复杂,会受到多种因素和挑战的影响,需要精心护理。本研究旨在确定下肢肿瘤假体手术后原发性骨肿瘤患者护理方面的挑战。

方法

通过病历回顾对丹麦哥本哈根里格霍斯医院在2016年11月5日至2020年4月1日期间治疗的15例患者进行回顾性队列研究,重点关注术后护理相关的挑战。在手术预约系统中识别出所有手术代码为“骨切除”的患者,并筛选其 eligibility。

结果

患者经历了术后挑战,如严重疼痛、活动延迟时间长(平均:4天)和排便延迟(平均:5天)。在里格霍斯医院的平均住院时间为13天。此外,11例患者(73%)报告睡眠中断和恶心。

结论

接受下肢肿瘤假体手术的患者面临着相当多的术后挑战,这些挑战导致住院时间延长。这些挑战,包括严重疼痛、活动延迟和胃肠道问题,对康复有显著影响。研究结果凸显了迫切需要有针对性的护理干预措施来有效解决这些问题。加强疼痛管理方案、早期活动策略和全面的术后护理计划对于改善患者预后和缩短住院时间至关重要。通过专门的护理来应对这些挑战对于优化接受下肢肿瘤假体患者的康复过程至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dba9/11452984/9462acd516fb/12912_2024_2400_Fig1_HTML.jpg

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