I. Preoperative care 1. Preoperative preparation: In addition to the routine preoperative neurosurgery preparation, it is necessary to make good electrical audiometry, magnetic angiography (MRA) and other examinations to carefully assess the frequency, intensity and duration of the occurrence of facial muscle spasm to provide comparison for postoperative care observation. Yang Haisheng, Department of Neurosurgery, The Second Hospital of Harbin Medical University 2. Psychological care.
Although facial muscle spasm is not life-threatening, but the involuntary facial appearance seriously hinders the social life and psychological health of patients, and even adversely affects the marriage and employment of some young patients, plus the course of the disease moved, delayed tossing and turning to seek medical treatment, subjected to repeated drug treatment, and even botulinum toxin injection treatment, so that some patients are in a state of high mental tension and emotional irritability for a long time, there are doubts about the effect of surgery, and are eager to talk about being They have doubts about the effect of surgery and are eager to be understood and cared for. Therefore, after admission, we listened patiently to the patients’ complaints while taking a detailed medical history. We understand, sympathize and comfort the patient’s pain and the discomfort caused by the disease, and guide him to vent his anguish, and explain in detail the purpose, method, effect of the operation and postoperative precautions, so that the patient can have more confidence and be in the best state of treatment. Postoperative care 1. General care: 6h after surgery, go to the pillow and lie down, closely observe whether there is active bleeding and changes in vital signs, pupils, limb activities and language. The postoperative nurse should understand the intraoperative situation in detail, so as to have a good idea, and report any abnormality to the doctor in time and give corresponding treatment. Continuous low-flow oxygenation for 24h postoperatively to prevent brain tissue edema around the incision. Pay attention to any symptoms of brainstem damage, observe any symptoms of increased intracranial pressure such as severe headache, frequent vomiting, slow pulse and elevated blood pressure, and be alert to the occurrence of secondary intracranial hemorrhage. After 12h postoperative water fasting, transition from liquid food to easily digestible high calorie, high vitamin and high protein diet. If transient facial numbness occurs, the food should not be too hard, too cold or too hot to avoid damaging the oral mucosa. 2. Observation of post-operative efficacy: The frequency intensity and duration of facial muscle spasm should be evaluated promptly after the patient is awake, and the time when the facial muscle spasm stops twitching should be recorded. Patients with severe facial muscle spasm can see an increase in the eye fissure on the affected side after surgery, which is due to the relaxation of the previously tense facial muscles after the cause of the disease is removed rather than due to facial nerve injury, and is the first sign of successful surgery. Although microvascular decompression lifts the vascular compression, the regeneration and repair of facial nerve root myelin and the stabilization of facial nerve motor nucleus excitability need a period of time to complete the observation of postoperative efficacy should be continued for more than 24 months.