diplomsko delo
Maja Magister (Author), Mirjam Ravljen (Reviewer), Manca Pajnič (Mentor), Mitja Benedičič (Co-mentor)

Abstract

Uvod: Operativni poseg stimulacije globokih možganskih jeder (DBS) je poseg, pri katerem se na točno določeno anatomsko mesto v možganih kirurško implantirajo elektrode z namenom uravnavanja patoloških signalizacij in izboljšanja simptomov pacientov s specifičnimi diagnozami. Operativni poseg se uporablja za zdravljenje simptomov kliničnih motenj gibanja kot sta Parkinsonova bolezen in esencialni tremor. Vstavljene elektrode so subkutano povezane s podaljški, ki vodijo do podkožno vstavljenega nevrostimulatorja, ki proizvaja električne impulze. Pri posegu lahko pride do številnih, a vendar redkih zapletov kot so intrakranialna krvavitev, možganska kap in okužbe. Pri operativnem posegu sodelujejo operacijske medicinske sestre (OPMS), ki so v grobem odgovorne za pacientovo varnost, poznati morajo anatomijo človeka, potek operacije, tehnike instrumentiranja in imeti ročne spretnosti za sestavljanje stereotaktičnih pripomočkov. Namen: V diplomskem delu smo se vsebinsko opredelili do anatomije in funkcij oziroma pomena globokih možganskih jeder, stereotaksije, poteka operacije stimulacije globokih možganskih jeder ter vloge OPMS pri omenjenem operativnem posegu. Namen diplomskega dela je s pomočjo strokovne in znanstvene literature predstaviti operativni poseg stimulacije globokih možganskih jeder. Cilj je predstaviti potek operativnega posega in opisati vlogo medicinske sestre pri operativnem posegu. Metode dela: Diplomsko delo temelji na deskriptivni metodi dela ter kvantitativnem raziskovanju, in sicer pregledu strokovne in znanstvene literature s pomočjo sledečih podatkovnih baz in brskalnikov: PubMed, COBBIS, Medline, Google učenjak, CINAHL in elektronske knjižnice Z-Library. Uporabljena je bila literatura v angleškem in slovenskem jeziku, s poudarkom na izvirnih in preglednih znanstvenih člankih ter elektronsko ali fizično dostopnih strokovnih učbenikih in priročnikih. Razprava in zaključek: Vloga OPMS pri operativnem posegu DBS je ključnega pomena za njegovo izvajanje. OPMS pomaga pri pripravi vseh potrebnih pripomočkov, aparatur, materiala, instrumentarskih miz, setov s kirurškimi inštrumenti in šivalnega materiala za izvedbo operativnega posega. V sodelovanju s člani operacijskega tima pomaga pri nameščanju pacienta v operativni položaj, pri katerem je pozorna na zmanjšanje možnosti nastanka poškodbe zaradi pritiska in na zaščito pacienta pred rentgenskimi žarki. Skrbi za ustrezno izpolnjen kirurški varnostni kontrolni seznam (KVKS), delujoče aparature v operacijski dvorani in za ustrezno sestavljena stereotaktični obroč in lok. Ves čas operacije skrbi za sterilnost in aseptičen način dela. Ob koncu operativnega posega je odgovorna za ustrezno oskrbljene rane, čistočo okoliške kože in odstranitev nepotrebnih pripomočkov s pacienta.

Keywords

diplomska dela;zdravstvena nega;operacijske medicinske sestre;globoka možganska stimulacija;bazalni gangliji;stereotaksija;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [M. Magister]
UDC: 616-083
COBISS: 75261443 Link will open in a new window
Views: 367
Downloads: 80
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Other data

Secondary language: English
Secondary title: Role of an operating room nurse during deep brain stimulation surgery
Secondary abstract: Introduction: Deep brain stimulation (DBS) is a surgical procedure with which electrodes are surgically implanted in a specifically located anatomical position in the brain, with the intention of pathological management of symptoms and signalizations in patients with specific diagnosis. The procedure is used for treatment of clinically diagnosed motoric disabilities such as Parkinson’s disease and essential tremor. The implanted electrodes are subcutaneously connected via connectors to a subcutaneously implanted neurostimulator, which generated electric impulses. There is a possibility of many, but extremely rare, surgical complications such as intracranial bleeding, stroke and infection. An operating room nurse is present during the procedure and is responsible for patient safety, knowing of the human anatomy and surgical procedure, handling and caring of surgical instruments and having the knowledge of assembling the stereotactic equipment. Purpose: In this diploma work, we defined the content of the anatomy, functions and the importance of deep brain nuclei, stereotaxy, the surgical procedure of DBS and the role of an operating room nurse during the procedure. The purpose of this diploma work is to present the DBS surgical procedure with the help of professional literature. The goal is to present the DBS surgical procedure and to describe the role of an operating room nurse during the procedure. Methods: This diploma work is based on a descriptive method of work and quantative research, namely a review of professional literature using the following databases and browsers: PubMed, COBBIS, Medline, Google Scholar, CINAHL and the use of electronic library Z-Library. Literature in English and Slovene was used, with an emphasis on original scientific articles and electronically or physically accessible professional textbooks and manuals. Discussion and conclusion: Operating room nurses during DBS surgery have a key role in its implementation. The nurse is responsible for the setup of all equipment, medical supply, instrument tables, surgical instrument sets and sutures necessary for the operation. With other members of the operating team, she assists in placing the patient in an operative position in which she pays attention to reducing the possibility of pressure injury and protecting the patient from X-rays. She is responsible for the surgical safety checklist, working equipment in the operating room and properly assembled stereotactic frame and arc. She is responsible for sterile and aseptic work throughout the operation. At the end of the surgical procedure, she takes proper care of the surgical wounds, cleans the surrounding skin and removes all unnecessary objects off the patient.
Secondary keywords: diploma theses;nursing care;operating room nurses;deep brain stimulation;basal ganglia;stereotaxy;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 23 str.
ID: 13321180