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在部脊髓损伤后放弃上肢重建手术:一种定性前性队列研究

Shady Elmaraghi¹, Allison J L'Hotta², Aimee S James³

¹Department of Plastic Surgery, Vanderbilt University, Nashville, TN.

The Journal of hand surgery

|August 8, 2025

概括

许多脊髓损伤 (SCI) 患者因恐惧,不切实际的期望或过去的负面经历而避免上肢手术. 需要改善关于手术风险和益处的沟通.

科学领域:

神经科学是一个神经科学.
整形外科手术整形外科手术
康复医学康复医学康复医学

背景情况:

恢复上肢 (UE) 功能是部脊髓损伤 (SCI) 患者的首要任务.
肌移植 (TT) 手术的发生率在美国很低,尽管有积极的结果.
较新的神经转移 (NT) 选择扩大了与SCI相关的UE功能障碍的治疗可能性.

研究的目的:

调查为什么符合条件的SCI患者选择不接受UE重建手术.
了解决策因素在传统的TT和较新的NT程序的背景下.

主要方法:

定性研究涉及半结构性访谈中椎SCI的成年人,他们拒绝了UE手术和他们的护理人员.
采访被转录,编码,并使用传统的内容分析进行分析.
结果总结为主题,遵循COREQ的指导方针.

主要成果:

16名参与者 (94%男性,平均年龄39岁) 和8名护理人员提供了数据.
放弃手术的主要原因包括对功能下降的恐惧,对更大收益的渴望,对现有功能的调整,竞争优先事项,对自然恢复的期望和之前的负面医疗保健经验.
在TT和NT程序中存在障碍.

结论:

尽管在SCI中用于UE恢复的NT增强TT的NT方面取得了进展,但手术重建仍然存在重大障碍.
加强共享决策至关重要,需要详细的信息关于手术风险,结果,和比较数据与自然恢复.
对于SCI患者而言,有效但未充分利用的外科选择需要更好地了解患者.

关键词:

神经移植手术是一种神经移植手术.质量上的影响是有质量的.进行外科手术的决策.肌移植手术是指肌移植手术.四肢四肢症是一种疾病.

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