ABSTRACT
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,intro-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 hemorrhage,wound care in the forearm and monitoring of graft.Compared with the preoperative period,levels of intact parathyroid hormone(iPTH),calcium 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 insomnia.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of auricular plaster therapy on quality of life in uremia patients after parathyroidectomy plus autograft (PTX+AT).</p><p><b>METHODS</b>A total of 34 uremia patients complicated with secondary hyperparathyroidism (SHPT) who received PTX+AT were randomly divided into an observation group and a control group, 17 cases in each one. The patients in the control group were treated with calcium supplementation after surgery, 1 to 2 mg/kg an hour; one day after surgery, the patients were treated with oral administration of calcium carbonate before meals, 1.5 g, three times per day, and calcitriol (0.5 to 4 μg/d) was added if necessary. None-heparin hemodialysis was performed for one week after surgery. Besides calcium supplementation, patients in the observation group were treated with auricular plaster therapy at Shenmen (TF), Jiaogan (AH), Neifenmi (CO) and Shen (CO). The laboratory indexes, including immunoreactive parathyroid hormone (iPTH), calcium, phosphorus, and SF-36 questionnaire, including 8 dimensions of physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotional (RE) and emotional well-being (EB), were observed before surgery and 1 week, 2 weeks, 4 weeks and 8 weeks after surgery in the two groups.</p><p><b>RESULTS</b>The iPTH in the two groups was significantly decreased 1 week, 2 weeks, 4 weeks and 8 weeks after surgery, and the serum calcium and phosphorus were also improved to a certain degree (all<0.05); however, the differences of iPTH, calcium and phosphorus between the two groups were not significant at each time point after surgery (all>0.05).The PF, RP, BP, GH, VT, SF, RE and EB of SF-36 in the two groups before surgery were lower than the normal score; after surgery, each dimension of SF-36 were improved to some extent in the two groups (all<0.05). Eight weeks after surgery, the improvement of PF, RP, BP, GH and EB in the observation group was superior to that in the control group (all<0.05); however, in terms of VT, SF and RE, no significant difference was observed between the two groups (all>0.05).</p><p><b>CONCLUSION</b>The auricular plaster therapy can improve the physical and mental health, relieve pain and improve quality of life in patients with uremia after PTX+AT, which is superior to calcium carbonate alone.</p>