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 Wysłany: Pon 22:25, 21 Mar 2011 Temat postu: Care of epidemic hemorrhagic fever _4480 |
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Care of epidemic hemorrhagic fever
Urine and urination on stage and reduce the chances of infection, shorter hospital stay. Epidemic hemorrhagic fever is a preventable and controllable, and rodent control and the strengthening of field protection can reduce the incidence of the disease, reduce the social and family burden. So we should vigorously promote the patriotic public health campaigns and health education in the church. Received 2OO4-04-22 (edit small way) the facial nerve cuff repair surgery Oral Care Hospital, Nanjing 210008,[link widoczny dla zalogowanych], China Yun-facial nerve anastomosis in microsurgery nerve stump surgery is generally a direct anastomosis or autologous nerve transplantation. The bushings to repair the facial nerve transection at present only theoretical research. Repair of the facial nerve on the casing is to change the growth characteristics of neural blind,[link widoczny dla zalogowanych], so within the limits of the human growth, in order to achieve the purpose of automatic match. Our hospital since 1993 were treated 32 cases of early facial paralysis patients underwent cuff repair,[link widoczny dla zalogowanych], after 6 months follow-up showed: high success rate, the results are satisfactory, and postoperative care will now be described below. The clinical data of 32 patients with 1 28 cases male, 5 female, age 56 years maximum, minimum 6 years old children, most injuries caused, in part accidental injury or need parotid tumor resection surgery, anesthesia generally use more local anesthesia, part of the scar clearly can not tolerate surgery and anesthesia of children with oral intubation. About 2 cases of patients with typical Ma × x, 36-year-old, male, due to cut facial laceration, the performance of the affected side of the nose can not flap, nasolabial fold ipsilateral disappearance of ipsilateral lower eyelid closure weakness, diagnosed as upper and lower buccal branch of facial nerve injury After a course of physical therapy, nerve damage can not be restored. Preoperative laboratory tests were all within the normal range, liver and kidney function was normal and found no surgical contraindications, scheduled for general anesthesia facial nerve cuff surgery goes well, little blood loss, patient safety and back ward, patients given after the anti-inflammatory treatment, 8d patients after discharge. 3 3.1 preoperative psychological nursing care of such patients generally have a history of trauma (such as cuts, stab wounds, falls) or parotid gland surgery line of fire. Therefore, most patients urgently need to change the bad appearance, made it clear that surgery patients and their families should be objective about your surgery, postoperative neurological recovery time, restore the degree of local anesthesia by the Church under local anesthesia with the patient how to tie in with the doctor, and to develop appropriate care plan. 3.2 Ask allergies, do penicillin skin test, such as preoperative neurotrophic VBI2,,, B6, and an appropriate amount of antibiotics to reduce the chance of infection. 3.3 The area of the skin in preparation for surgery, before the top of the tragus and the tragus three fingers at the back of the net three fingers at the hair shaved clean. 3.4 patients undergoing general anesthesia on the morning of fasting, according to patient's condition the night before surgery the right amount of oral sedative hypnotics, luminal sodium 0.09g. Intramuscular injection on the morning of surgery luminal 0.1g atropine 0.3mg. To achieve the emotional stability of patients and reduce the gland secretion, reducing the amount of local anesthetic. 4 items for surgery with 4.1: Conventional facial nerve dissection equipment package (12 in Bend, l2 the small bend, retractor 1 on a plastic tweezers) and dressing big bag to keep separate microvascular clamp 2, microscopic plastic tweezers 2, a micro needle holder, cut a microstructure. No damage, and thread diameter 2ram medical silicone tube about 1 paragraph. 4.2 Patient Preparation: Patient changing his shoes into the operating room, with good hands and know what belt, elastic fit, unlock the collar, shoulder pads with soft pillows, so that patients with head thrown back, and turned to the healthy side, the head of two side of the sandbags fixed. 4.3 Summary After surgery: to help doctors and auxiliary towel routine disinfection, connecting suction,[link widoczny dla zalogowanych], electrocautery device, marking the crystal violet prepared in the tragus to the mandibular inferior border to do before the to the parotid fascia shallow bite will flap off the top of the separation of the mandibular angle to expose the facial nerve marginal mandibular branch, and then find the nerve from the off, remove the two ends of the surrounding tissue, cut the two stump scar tissue, measuring the gap at both ends, length and width of the corresponding medical silicone tube set of people,[link widoczny dla zalogowanych], cutting length, the two ends of the facial nerve within the silicone tube sets of people, two with no damage silk suture, and then suture level, set one rubber drainage strip, pressure dressing the wound. See Figure 1.5 5.1 Postoperative care is not awake anesthesia given to patients with hand guard pillow lying, attention to vital signs, nasal discharge and timely export suction to ensure airway patency, clear given after the patient semi-supine, to reduce facial swelling, note the color change dressings. 5.2 after giving high-protein, high vitamins, high calorie liquid half of the flow of a soft diet until the normal diet, avoiding spicy stimulation. Create the appropriate pressure bandage 5.3 technique to prevent anastomotic edema and compression of the facial nerve and reduce the gland secretion, to prevent the saliva leakage. Oral administration of neurotrophic drugs VBI2, v86 while oral atropine 0.3mg, 3 times / d, regular dressing, 2d section after removing the rubber drain.
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