25例甲状旁腺全切加前臂自体移植患者的围手术期护理

Perioperative nursing care of 25 patients underwent total parathyroidectomy with forearm autograft

总结25例因继发性甲状旁腺功能亢进接受甲状旁腺全切加前臂自体移植术患者的护理要点,整个围手术期采用医护一体化模式,重点关注以下护理要点:围手术期内环境管理,血管通路的护理,术中标本管理,麻醉及复苏室护理管理,采血管理,术后低钙血症的处理及护理,感染及出血的预防及护理,前臂切口护理及移植物监测。与术前相比,术后的全段甲状旁腺激素水平、钙、磷水平均明显下降(P<0.01);术后患者骨关节疼痛、皮肤瘙痒、肌无力、失眠症状明显改善。

To summarize key points of nursing care of 25 patients with secondary hyperparathyroidism underwent parathyroid autotransplantation with forearm （tPTX＋AT）. The integrated mode was adopted during the perioperative period,focusing on the following key points：perioperative management of environment,nursing of vascular access,in- tro-operative management of sample,nursing management during anesthesia and recovery,management of drawing blood ,treatment and nursing care of postoperative hypocalcemia,prevention and nursing care of infection and hem- orrhage,wound care in the forearm and monitoring of graft. Compared with the preoperative period,levels of intact parathyroid hormone（iPTH）,ealeium and phosphorus were significantly decreased during the postoperative period（P〈 0.01）;symptoms were significantly improved after surgery included bone and joint pain,muscular weakness,and in- somnia.