护理干预对于椎体前食管后通路健侧颈7神经移位术治疗中枢性偏瘫的过程中预防术中压力性损伤和复苏期躁动的效果  

Effect of nursing intervention on prevention of intraoperative stress injury and resuscitated agitation in the treatment of central hemiplegia by transposition of healthy side cervical 7 nerve through anterior vertebral esophagus and posterior access

作　　者：陈燕 李根娣 CHEN Yan;LI Gendi(Operating Room,Huashan Hospital Affiliated to Fudan University,Shanghai200040,China)

机构地区：[1]复旦大学附属华山医院手术室,上海200040

出　　处：《中国医药导报》2021年第5期193-196,共4页China Medical Herald

摘　　要：目的探索护理干预对于椎体前食管后通路健侧颈7神经移位术(简称“改良健侧颈7神经移位术”)治疗中枢性肢体偏瘫的过程中预防术中压力性损伤和复苏期躁动的效果。方法选择2018年3月—2019年1月在复旦大学附属华山医院接受改良健侧颈7神经移位术治疗的18例中枢性偏瘫患者,采取有效的护理干预措施,包括术前术中压力性损伤评估,通过图片/视频帮助患者手术室环境以减轻患者恐惧/焦虑;术中控制温度并对于受压部位采取有效的保护等预防压力性损伤的措施,术后复苏期密切关注患者情况,给予及时的疏导安慰,观察术中压力性损伤和复苏期躁动的发生情况。结果经过围术期护理干预,18例患者均顺利完成改良健侧颈7神经移位术,未发生术中压力性损伤和严重的复苏期躁动。结论通过系统性的护理干预,可以有效预防椎体前食管后通路健侧颈7神经移位手术中的术中压力性损伤发生、预防/减轻复苏期躁动。Objective To explore the effect of nursing intervention on the prevention of intraoperative stress injury and resuscitated agitation during the treatment of central limb hemiplegia by the anterior and posterior vertebral esophagus access healthy side cervical 7 nerve transposition(“modified contralateral cervical 7 nerve transposition”).Methods A total of 18 patients with central hemiplegia who received improved contralateral cervical 7 nerve transposition in Huashan Hospital Affiliated to Fudan University from March 2018 to January 2019 were selected,take effective nursing intervention measures,including preoperative and intraoperative stress injury assessment.The pictures/videos to help patients with the operating room environment to reduce fear/anxiety were used.Temperature control and effective protection of the compression site were taken to prevent pressure injury during operation.In the postoperative recovery period,the patient’s condition was closely paid attention to,timely counseling and comfort were given,and the occurrence of intraoperative stress injury and restlessness in the recovery period was observed.Results After perioperative nursing intervention,all 18 patients successfully completed the modified contralateral cervical 7 nerve transposition,without intraoperative stress injury and serious resuscitated agitation.Conclusion Systemic nursing intervention can effectively prevent intraoperative stress injury and prevent/reduce resuscitated agitation during the operation of contralateral cervical 7 nerve transposition on the healthy side through the anterior vertebral esophagus and posterior access.

关 键 词：神经移位 中枢性偏瘫 手术护理 术中压力性损伤 复苏期躁动 

分 类 号：R682.2[医药卫生—骨科学]