1例双下肢瘫痪患者植入脊髓神经刺激器的护理

doi:10.3761/j.issn.0254-1769.2023.18.012

中华护理杂志 ›› 2023, Vol. 58 ›› Issue (18): 2257-2260.DOI: 10.3761/j.issn.0254-1769.2023.18.012

1例双下肢瘫痪患者植入脊髓神经刺激器的护理

朱钰(), 于圆梦, 张帅, 刘云阳, 张松, 白鸿瑞, 刘春英()

300192 天津市天津市第一中心医院手术室（朱钰，于圆梦，张帅，张松，白鸿瑞，刘春英），神经外科（刘云阳）

收稿日期:2022-10-09 出版日期:2023-09-20 发布日期:2023-09-22
通讯作者: 刘春英，E-mail：liu000571@163.com
作者简介:朱钰：女，本科，副主任护师，E-mail：157998903@qq.com

Nursing cooperation of a case of spinal nerve stimulator implantation in the treatment of lower extremity paralysis surgery

ZHU Yu(), YU Yuanmeng, ZHANG Shuai, LIU Yunyang, ZHANG Song, BAI Hongrui, LIU Chunying()

Received:2022-10-09 Online:2023-09-20 Published:2023-09-22

摘要/Abstract

摘要：

总结1例双下肢瘫痪患者植入脊髓神经刺激器的护理经验。护理要点：组间多学科协作团队，进行充分的术前准备，保证手术质量；密切观察并及时反馈电生理监测运行情况，确保手术操作精准度；科学快速筛查术中获得性压力性损伤风险，保障侧卧位安全；精细配合术中唤醒，保障电极植入位置精准；严格防控切口感染风险，健全防御机制；开展术后随访，提升延续护理质量。患者手术顺利，术后1个月电极开机，臀部和左下肢出现知觉。

关键词: 脊髓损伤, 脊髓刺激器,植入, 截瘫, 手术配合, 围手术期护理

Abstract:

To summarize the nursing cooperation experience of a spinal cord injury patient with spinal cord nerve stimulator implantation in the treatment of paralysis of both lower limbs. Rigorous perioperative care was provided for patients；multidisciplinary collaborative diagnostic and treatment teams were established and participated in；a surgical support system was established；close observation and timely feedback on the operation of electrophysiological monitoring was conducted to ensure the accuracy of surgical operations；the safety of surgical posture was assessed using the CORN Intraoperative Acquired Stress Injury Risk Assessment Scale；fine cooperation with patients during the awake period of surgery was to ensure accurate electrode placement；stringent risk management and control of incision infection and sound defense mechanisms were conducted. The patient’s surgery was successful，and a month after the surgery，the electrodes were turned on，and sensation appeared in the hip and left lower limb.

Key words: Spinal Cord Injuries, Spinal Cord Stimulator,Implantation, Paraplegia, Surgical Coordination, Perioperative Nursing

朱钰, 于圆梦, 张帅, 刘云阳, 张松, 白鸿瑞, 刘春英. 1例双下肢瘫痪患者植入脊髓神经刺激器的护理[J]. 中华护理杂志, 2023, 58(18): 2257-2260.

ZHU Yu, YU Yuanmeng, ZHANG Shuai, LIU Yunyang, ZHANG Song, BAI Hongrui, LIU Chunying. Nursing cooperation of a case of spinal nerve stimulator implantation in the treatment of lower extremity paralysis surgery[J]. Chinese Journal of Nursing, 2023, 58(18): 2257-2260.

参考文献 13

[1]	Hutson TH, Di Giovanni S. The translational landscape in spi-nal cord injury:focus on neuroplasticity and regeneration[J]. Nat Rev Neurol, 2019, 15(12):732-745. DOI
[2]	李文选, 李瑞峰, 于宝龙. 2012—2019年度956例创伤性脊髓损伤住院患者流行病学分析[J]. 中国脊柱脊髓杂志, 2021, 31(7):626-631.
	Li WX, Li RF, Yu BL. Epidemiological analysis of 956 inpa-tients with traumatic spinal cord injury from 2012 to 2019[J]. Chin J Spinal Cord, 2021, 31(7):626-631.
[3]	韩妍, 陆洋, 王劲, 等. 硬膜外脊髓电刺激治疗脊髓损伤后运动障碍的研究进展[J]. 中华神经医学杂志, 2021, 20(10):1070-1075.
	Han Y, Lu Y, Wang J, et al. Research progress in the treat-ment of motor dysfunction after spinal cord injury by epidural spinal cord electrical stimulation[J]. Chin J Neuromedicine, 2021, 20(10):1070-1075.
[4]	张明园. 精神科评定量表手册[M]. 长沙: 湖南科学技术出版社, 2015:143-181.
	Zhang MY. Handbook of psychiatric rating scale[M]. Changsha: Hunan Science and Technology Publishing House, 2015:143-181.
[5]	任永霞, 王楠, 韩赛, 等. 手术场景适应性训练在眼科幽闭恐惧患者中的应用[J]. 中华护理杂志, 2018, 53(9):1039-1043.
	Ren YX, Wang N, Han S, et al. Application of adaptive train-ing of surgical scene in patients with claustrophobia in ophthalmology[J]. Chin J Nurs, 2018, 53(9):1039-1043.
[6]	Strike SA, Hassanzadeh H, Jain A, et al. Intraoperative neuro-monitoring in pediatric and adult spine deformity surgery[J]. Clin Spine Surg, 2017, 30(9):E1174-E1181. DOI URL
[7]	Mervis JS, Phillips TJ. Pressure ulcers:prevention and manage-ment[J]. J Am Acad Dermatol, 2019, 81(4):893-902. DOI URL
[8]	Grap MJ, Schubert CM, Munro CL, et al. Or time and sacral pressure injuries in critically ill surgical patients[J]. AORN J, 2019, 109(2):229-239. DOI PMID
[9]	Bulfone G, Marzoli I, Quattrin R, et al. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres[J]. J Perioper Pragt, 2012, 22(2):50-56.
[10]	罗彩凤, 贾静, 柏素萍, 等. 围手术期患者压疮评估及评估工具使用现状的调查研究[J]. 中华护理杂志, 2017, 52(4):409-413.
	Luo CF, Jia J, Bai SP, et al. Investigation and study on the status quo of pressure sore evaluation and evaluation tool use in perioperative patients[J]. Chin J Nurs, 2017, 52(4):409-413.
[11]	李强, 曾菲, 陈涛, 等. 极重度脊柱侧凸矫形术中唤醒质量的影响因素分析[J]. 实用骨科杂志, 2022, 28(2):103-108.
	Li Q, Zeng F, Chen T, et al. Risk factors influencing quality of intraoperative wake-up test for extremely severe scoliosis surgery[J]. J Pract Orthopaedics, 2022, 28(2):103-108.
[12]	国家卫生计生委, 国家中医药管理局, 解放军总后勤部卫生部. 抗菌药物临床应用指导原则(2015版)[M]. 北京: 人民卫生出版社, 2015:3-5.
	National Health and Family Planning Commission, State Administration of Traditional Chinese Medicine, the People’s Liberation Army General Logistics Department of the Ministry of Health. Guiding principles of clinical application of anti-bacterial(2015 edition)[M]. Beijing: People’s Medical Publi-shing House, 2015:3-5.
[13]	Smith JS, Fu KM, Polly DJ, et al. Complication rates of three common spine procedures and rates of thromboembolism following spine surgery based on 108,419 procedures:a report from the Scoliosis Research Society Morbidity and Mortality Committee[J]. Spine, 2010, 35(24):2140-2149. DOI URL

[1]	孙瑜, 顾莺, 王慧美. 1例川崎病合并巨大冠状动脉瘤患儿的围手术期护理[J]. 中华护理杂志, 2023, 58(5): 595-599.
[2]	王林, 王冉, 刘婷, 曹朋, 赵磊. 非糖尿病老年患者术中血糖异常风险预测模型的构建及验证[J]. 中华护理杂志, 2023, 58(3): 318-324.
[3]	王慧美, 顾莺, 陈超, 孙瑜, 王威威. 1例先天性喉裂合并喉软骨软化病患儿的围手术期护理[J]. 中华护理杂志, 2023, 58(18): 2252-2256.
[4]	覃梦霞, 潜艳, 徐蓉, 董翠萍, 蔡纯. 基于互联网+肺康复全程健康教育在肺癌手术患者中的应用[J]. 中华护理杂志, 2023, 58(15): 1808-1814.
[5]	孙彩云, 仲骏. 全球首例双分支主动脉术中支架植入术患者的护理[J]. 中华护理杂志, 2023, 58(15): 1869-1873.
[6]	邓雁, 余琼, 武福姣, 方亮. 基于自我效能理论的护理干预对食管癌根治术后患者的影响[J]. 中华护理杂志, 2022, 57(9): 1042-1047.
[7]	李雪苹, 王磊, 张淮, 邢爱珍, 陈朝红, 尹志勤. Stanford A型主动脉夹层患者术后谵妄风险预测评分模型的构建与效果验证[J]. 中华护理杂志, 2022, 57(8): 950-957.
[8]	张燕, 徐敏, 陈丽莉, 余婷, 陈娜, 汪炜健. 1例左心房巨大球形血栓致急性左心衰竭患者围手术期的护理[J]. 中华护理杂志, 2022, 57(7): 859-862.
[9]	兰美娟, 曾妃, 梁江淑渊. 双肺移植患者肺康复方案的构建及应用[J]. 中华护理杂志, 2022, 57(6): 659-665.
[10]	卢芳燕, 董丽, 刘元, 王燕, 戴燕红, 吕斐翠, 王华芬. 儿童肝移植围手术期护理质量评价指标体系的构建[J]. 中华护理杂志, 2022, 57(6): 666-672.
[11]	梁永春, 周海琴, 朱雪芬, 曹晓东, 闵群惠, 黄珂瑶. 肺移植特异性生活质量量表的汉化及信效度检验[J]. 中华护理杂志, 2022, 57(6): 688-694.
[12]	余群飞, 张玉萍, 任英, 许国萍, 马姚静, 赵腾飞. 1例Ⅲ型戈谢病伴重度脊柱后凸畸形患儿的围手术期护理[J]. 中华护理杂志, 2022, 57(6): 736-739.
[13]	中华护理学会外科护理专业委员会, 中华医学会外科学分会护理学组, （执笔：马玉芬, 徐园, 王晓杰, 邓海波, 王磊, 孙建华, 刘戈, 郭雅萍, 耿倩, 王钰, 朱丽筠, 鲁乔丹, 安然逊）. 普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识[J]. 中华护理杂志, 2022, 57(4): 444-448.
[14]	王玉伟, 李慧, 李银玲, 赵丽慧. 7例Stanford A型主动脉夹层合并肠系膜上动脉缺血患者的术后护理[J]. 中华护理杂志, 2022, 57(4): 476-480.
[15]	林燕, 俞超, 王奉涛, 高春华, 张帅, 褚君卿. 2例异基因造血干细胞移植术后移植物抗宿主病患者行肺移植术的护理[J]. 中华护理杂志, 2022, 57(4): 481-485.

1例双下肢瘫痪患者植入脊髓神经刺激器的护理

Nursing cooperation of a case of spinal nerve stimulator implantation in the treatment of lower extremity paralysis surgery

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 13

相关文章 15

编辑推荐

Metrics