断指再植围手术期护理（replantation of amputated finger, perioperative nursing）

断指再植围手术期护理（REPLANTATIONOFAMPUTATEDFINGER,PERIOPERATIVENURSING）REPLANTATIONOFAMPUTATEDFINGER,PERIOPERATIVENURSINGRELEVANTKNOWLEDGEAFINGERREFERSTOTHEPHYSICALTRAUMAAFTERTRANSECTIONOFTHEDISTALFINGERJOINTTWOCLASSIFICATIONOFSEVEREDFINGERSACCORDINGTOTHEDEGREEOFFINGERINJURY,THEYAREDIVIDEDINTOCOMPLETEAMPUTATIONANDINCOMPLETEAMPUTATION1COMPLETELYSEVEREDBREAKINGAWAYFROMTHEPROXIMALANDDISTALFINGERSSEPARATEDCOMPLETELY,WITHOUTANYORGANIZATIONORBETWEENTHETWOENDSARECONNECTED,THEREARESOMESERIOUSCONTUSIONOFTHEORGANIZATIONISINTHEDEBRIDEMENT,CONTUSIONTISSUEMUSTBEREMOVED,HASACTUALLYBECOMECOMPLETELYSEVERED2INCOMPLETETRANSECTIONMOSTINJUREDFINGERAMPUTATION,ONLYALITTLESKINORSOFTTISSUEISTHATCONNECTIVETISSUEAREAISLESSTHANTHECROSSSECTIONOFTHE1/4FINGER,ORISLESSTHANTHECIRCUMFERENCEOFTHE1/8FINGERSKIN,SOFTTISSUEISONLYARTERYORVEINANDNERVEANDTENDONTISSUE,BUTNOTTHEREISBLOODCIRCULATION,WITHOUTVASCULARANASTOMOSISWASCALLEDINCOMPLETETRANSECTIONTHREE,THECOMMONCAUSEOFINJURYCUTTINGINJURY,ELECTRICSAWINJURY,CRUSHINJURY,STAMPING,AVULSIONINJURYFOUR、ONSITEEMERGENCYTREATMENT1IFTHELIMBSAREINVOLVEDINTHEMACHINE,SHOULDSTOPIMMEDIATELY,ABSOLUTELYNOTALLOWEDTOTURNTHEMACHINEBACK,YOUSHOULDOPENTHEMACHINE,REMOVETHEFINGERS,OTHERWISETHELIMBSWILLBEDAMAGEDAGAIN2,FINGERLIMBWOUNDBLOODVESSELRETRACTIONWILLSOONHAVETHROMBOSIS,ANDNEARTHEUSEOFCLEANDRESSINGORCLOTHTYPEPRESSUREBANDAGE,PREFERABLYWITHBANDAGE,BANDAGESHOULDBEFORCEDTOPREVENTBLEEDING3FINGERSLIMBSBESTWITHOUTTOURNIQUET,MUSTBEUSEDTOPADDRESSING,EVERYHOURRELAXATTHESAMETIMEFINGERPROXIMALTRUNKARTERYTOREDUCEBLEEDING,ACCURATERECORDSOFTOURNIQUET,PREVENTTHEAGGRAVATIONOFLONGTIME4PAYATTENTIONTOPROPERBANDAGINGANDFIXINGOFLIMBSSOASTOAVOIDINJURYDURINGTRANSFER5IFTHEPATIENTISSUFFERINGFROMSHOCK,TAKEANTISHOCKTHERAPYFIRSTANDTRANSFERITWHENTHECONDITIONPERMITS6,BREAKINGLIMBSTRYTOKEEPREFRIGERATED,DONOTSOAKINANYLIQUID,COLDSTORAGETOAVOIDDIRECTCONTACTWITHICE,SOASNOTTOFROSTBITE7USETHEFASTESTMEANSOFTRANSPORTATIONTOSENDTHEPATIENTTOAHOSPITALWHERETHEOPERATIONISPERFORMEDFIVEPRESERVATIONOFSEVEREDFINGERSTHEPRESERVATIONOFSEVEREDFINGERSCANREDUCETHEMETABOLISMOFTISSUES,SLOWDOWNTHEDEGENERATIONOFTISSUESANDPROLONGTHEIRLIFE,ANDCREATEBETTERCONDITIONSFORTHESURVIVALOFAMPUTATEDFINGERSWHERETHESEVEREDFINGERREQUIREDAFTERAPERIODOFTIMEANDLONGDISTANCECARRIERS,USINGTHEFOLLOWINGMETHODSTHEBESTPRESERVEDFINGERWITH4LAYERSOFCLEANGAUZEWRAPPED,THENADDNOHOLESINTHEPLASTICBAG,TIETHEBAG,THEBAGMOUTHUPWARD,ANDTHENPUTINTOTHEICEBOTTLEOROTHERCONTAINERS,ANDTHE2/3ISBURIEDWITHINTHEICE,CLOSEDTHEBOTTLEDONOTDUMPICEBOTTLEDELIVERYDONOTIMMERSETHEFINGERINVARIOUSDISINFECTANTANDPHYSIOLOGICALSALINE,ORIMMERSEITINALCOHOLORGRAPEJUICESIXMAJORINDICATIONSFORREPLANTATION1GENERALCONDITIONTHEGENERALSITUATIONISSTABLE,THEREISNOOBVIOUSCOMPOUNDINJURY,NOORGANICDISEASESANDBLEEDINGTENDENCY,NORMALMENTALANDCONSCIOUSNESS,ANDTHEREPLANTEDPATIENTSAREREQUIRED2THETWOENDSOFLOCALSTRUCTURALINTEGRITY,NOOBVIOUSLIMBSOFTTISSUECONTUSIONANDMULTIPLEFRACTURES,NEATSECTION,BLOODVESSELS,NERVES,MUSCLEORTENDONAVULSIONINJURYANDCONTUSIONWEREEXTRACTED,ESTIMATEDAFTERREPLANTATIONCANRESTOREACERTAINFUNCTION,EVENSHORTER,ALSOFORTHERECONSTRUCTIONOFBLOODCIRCULATIONIN24HOURS,THESURVIVALOFNURSINGFIRST,PREOPERATIVECARE1PREOPERATIVE6HOURSFASTING,NODRINKINGWATER,PREVENTTHEGASTRICCONTENTSONYANGSTRAYEDINTOTHETRACHEATOASPHYXIA2DRUGSUSCEPTIBILITYTESTPENICILLINSKINTEST,PROULXKAINPSEMERGENCYTRAUMAPATIENTSNEEDTATSKINTEST,FORFURTHERDRUGTREATMENTTOPREPARE3ROUTINEBLOODTEST,ROUTINEBLOODTEST,FOURITEMSOFBLOODCOAGULATIONANDELECTROCARDIOGRAMBEFOREOPERATION,ARETHEYSUITABLEFOROPERATIONBLOODTRANSFUSIONISEXPECTEDINPATIENTSUNDERGOINGPREOPERATIVEBLOODTRANSFUSION,BLOODTYPING,ANTIBODYPREPARATION,BLOODPREPARATIONANDSOON4,PREOPERATIVEPATIENTSSHOULDDOSURGICALAREASKINCLEAN,CUTFINGER/TOENAIL,DRESSEDINPATIENTCLOTHES,BANDGAPOFALLKINDSOFJEWELRY,DONOTMAKEUP5,PREOPERATIVEANTIBIOTICS,PREVENTIONOFINFECTION6,30MINUTESBEFORETHEINJECTIONOFDRUGSTOCALMANDINHIBITGLANDULARSECRETION,TOENHANCETHEEFFECTOFANESTHESIA,BENEFITOPERATION7WHENNECESSARY,PREOPERATIVECATHETERIZATIONISUSEDFORPATIENTSWITHLONGOPERATIONTIMEANDGENERALANESTHESIA8DOGOODPREOPERATIVEGUIDANCE,INCLUDINGPSYCHOLOGICALCARETWO、POSTOPERATIVECARE1THEPATIENTSAFTERREPLANTATIONOFGENERALCAREAREARRANGEDINAQUIET,COMFORTABLEANDFRESHAIRWARD,THETEMPERATUREIS2325,ANDTHEHUMIDITYIS5060MONITORINGOFVITALSIGNSTOSMOOTH,LYINGINBEDFOR7TO10DAYS,WITHHANDONTHEPILLOW,ELEVATIONOFABOUT30DEGC,THEHANDISSLIGHTLYHIGHERTHANTHELEVELOFTHEHEART,INORDERTOMAINTAINASTABLEANDEFFECTIVECIRCULATINGBLOODVOLUME,ANDISBENEFICIALTOTHEVENOUSLYMPHATICANDREDUCELOCALEDEMATHELOCALRADIATIONOFTHE60WSIDELAMPISPLACEDABOVETHEHAND,THEDISTANCEISABOUT40CM,THELOCALTEMPERATUREISMAINTAINED,ANDTHECHANGESOFTHEBLOODFLOWOFTHEFINGERSAREOBSERVEDEASILYSMOKINGISSTRICTLYFORBIDDENINTHEWARDSOASTOPREVENTFINGERSPASM2OBSERVATIONOFLOCALBLOODCIRCULATION21OBSERVATIONPOINTS1THECOLOROFTHEFINGERSISNORMALAFTERFINGERREPLANTATION,THEFINGERSAREREDORCLOSETOTHESKINOFTHEFINGERSSUCHASTHEBODYFROMTHETIDEREDTOPALE,ANDTHELOWERABDOMINALTENSION,INDICATINGTHATTHEFINGERISINTHEISCHEMICSTATE,CANBECAUSEDBYARTERIALSPASMOREMBOLISM,ANDAFTERCONSERVATIVETREATMENT,NOIMPROVEMENTCANBECONSIDEREDAFTERSURGICALEXPLORATIONSUCHASTHEBODYFROMFLUSHINGTODARKPURPLE,ANDREFERSTOTHEABDOMINALTENSIONINCREASED,INDICATINGVENOUSREFLUXOBSTRUCTION,ATTHISTIMECANTAKETHEHANDLIFT,REMOVEPARTOFTHESKINSUTUREORSMALLINCISION,SMALLAMOUNTOFBLOODLETTINGTORELIEVESYMPTOMSFINGERCOLORISTHEMAININDEXOFBLOODOBSERVATIONAFTERREPLANTATIONOFAMPUTATEDFINGERITISAFFECTEDBYINTERFERENCEFACTORSSUCHASLIGHTNATURALLIGHT,LIGHT,SKINPIGMENTNATIONALITY,REGION,INDIVIDUAL2FINGERSTEMPERATUREREFERSTOTHEBODYSKINTEMPERATUREIS33TO35DEGC,ANDTHEFINGERTEMPERATUREISBASICALLYTHESAMEORLOW1TO2DEGC,SUCHASLESSTHAN34DEGCORFURTHERDECREASEDTHEBLOODCIRCULATIONDISORDER,THEPATIENTSWERETREATEDATTHEDISCRETIONOFTHETHESKINTEMPERATUREISNOLONGERINTHEBLOODSUPPLYOFSENSITIVEOBSERVATIONINDEXITISEASILYAFFECTEDBYTHEFOLLOWINGFACTORSAINTERFERENCEATROOMTEMPERATUREANDWITHTHELOCALTEMPERATUREDIGITSFORTHELOSSOFNERVETISSUE,TEMPERATUREREGULATINGFUNCTIONLOSS,EASILYINFLUENCEDBYTHEEXTERNALTEMPERATURE,ESPECIALLYTHELOCALHIGHTEMPERATURELAMP,THETEMPERATUREOFTHESKINDOESNOTCONFORMTOTHEACTUALSITUATIONBEXPOSURETIMETHEREPLANTEDTISSUEISWRAPPEDWITHAMULTILAYERGAUZEPADTOKEEPWARMONCEEXPOSED,THESKINTEMPERATURECHANGESWITHTHEENVIRONMENTALTEMPERATURECREDUCTIONINCISIONAFTERTHEREDUCTIONOFTHEWOUNDDUETOTHEBLOODCIRCULATIONCRISIS,THEBLOODOOZINGFROMTHETISSUECANAFFECTTHEMEASUREMENTOFTHESKINTEMPERATURE3FINGERTENSIONSWELLINGNORMALINDEXSLIGHTSWELLING,“SAIDTHEREISSWELLING,BUTSKINYETEXIST,WITHTHE“SAIDSWELLINGSIGNIFICANTLY,STRIAEDISAPPEARED,WITH“SAIDEXTREMESWELLING,BLISTERSONTHESKIN,WITH“SAIDIFTHETENSIONISTOOLARGEANDTHECOLORPURPLEREFERSTOTHEBODYOFSAIDVENOUSREFLUXDISORDER,SUCHASPULPHYPOTONIA,COLORBYFLUSHINGTOPALETHEARTERIALBLOODDISORDERTHEABDOMINALTENSIONISRARELYINTERFEREDBYEXTERNALFACTORS,ANDITISARELIABLEOBSERVATIONINDEXOFBLOODCIRCULATION4THECAPILLARYFILLINGTEST,WHENTHEFINGERORCOTTONFINGERISPRESSEDONTHEBELLYORNAIL,THECOMPRESSEDFINGERTURNSFROMFLUSHINGTOPALEWHITE,ANDTHENRESTORESTOTHEORIGINALSTATEAFTERLOOSENINGANDPRESSINGTHEPHENOMENONOFCAPILLARYFILLINGPHENOMENONISNORMAL,TIMEIS12S,SUCHASFILLINGPHENOMENONQUICKLYANDHAVEABODYCOLOROFDARKPURPLEFORVENOUSREFLUXDISORDER,SUCHASFILLINGPHENOMENONDISAPPEAREDORELASTICFORREDUCEARTERIALBLOODDISORDERCAPILLARYREFLUXISANOBJECTIVEOBSERVATIONINDEXWHICHISRARELYINTERFEREDBYEXTERNALFACTORS,ANDITISTHEMOSTSENSITIVEINDEXFORJUDGINGWHETHERTHEREISBLOODCIRCULATIONORNOT5THEENDOFINCISIONBLEEDINGAFTERREPLANTATIONOFSEVEREDFINGERTESTFINGERWITHASMALLKNIFECUTIMMEDIATELYAFTERTHEBRIGHTREDBLOOD,SUCHASINCISIONWOUNDBLEEDINGORBYSQUEEZEONLYALITTLEBLOODEXUDATIONSAIDTOTHEARTERIALBLOODDISORDER,SUCHASINCISIONAFTERDARKPURPLEBLOODISTHERAPIDOUTFLOWOFBLOODSOONDARKPURPLETOBRIGHTREDINDICATESVENOUSREFLUXDISORDERFINGERTIPSMALLINCISIONBLOODLETTINGTESTISTHEMOSTDIRECTINDEXINJUDGINGWHETHERTHEREISBLOODCIRCULATIONORNOTINREPLANTATIONFINGER22VASCULARCRISISANDMANAGEMENT1ARTERYSPASMVASOSPASMAFTEROPERATION,OFTENBECAUSEOFCOLD,PAIN,NERVOUSNESS,DEPRESSIONORCRYINGANDSMOKINGINDUCEDFACTORS,OCCURREDINTHEPOSTOPERATIVE1D3D,THECLINICALMANIFESTATIONSOFBODYPALEWHITEORPALEGRAY,REFERSTOTHETEMPERATUREDROP,FINGERCOLLAPSE,NOCAPILLARYFILLINGPHENOMENONREFERSTOTHEENDOFTHESMALLINCISIONBLEEDINGATTHISPOINT,THECAUSEOFTHEARTERYSPASMSHOULDBESOUGHTANDREMOVEDHOWTODOITFIRST,LOOKFORTHECAUSEOFTHEARTERYSPASMWHERETHEROOMTEMPERATUREISLOW,THEPATIENTHASCOLDINSULATIONMEASURESSHOULDBETAKENFORPAIN,SHOULDBEINJECTIONAFTERREPLANTATIONOFSEVEREDFINGERFORCRYINGCAUSEDBYVASCULARSPASM,CANUSEHIBERNATIONOROTHERSEDATIVESTOQUIETSLEEPINADDITIONTOTHEABOVEMEASURES,SHOULDBEATTHESAMETIMEINTRAMUSCULARINJECTIONOFPAPAVERINEOROTHERVASCULARANTISPASMODIC,ANDCLOSEOBSERVATIONOFBODYCHANGES,GENERALLYAFTER2030MINUTESCANRELIEVEARTERYSPASM2ARTERIALEMBOLISMITISOFTENCAUSEDBYINCOMPLETEDEBRIDEMENTOFBLOODVESSELS,POORSUTUREQUALITYOFBLOODVESSELOREXCESSIVETENSIONOFVASCULARANASTOMOSISITCANALSOBECAUSEDBYHEMATOMACOMPRESSION,LOCALINFECTIONANDCHRONICVASOSPASMOFARTERYMOSTOFTHEARTERIALEMBOLISMOCCURREDWITHIN1TO3DAYSAFTEROPERATION,ANDITWASMOREFREQUENT24HOURSAFTEROPERATIONTHECLINICALMANIFESTATIONSANDVASOSPASMARTERYEMBOLIZATIONINBOTHTHESAME,ITISDIFFICULTTOIDENTIFYEARLY,ONLYAFTERSPASMOLYSISOBSERVATIONAFTERAPERIODOFTIMETHATBODYSTILLNOIMPROVEMENTOFBLOODCIRCULATION,TOILLUSTRATETHEARTERIALEMBOLIZATION,LAPAROTOMYSHOULDBECONSIDERED3VENOUSEMBOLISMTHEMAINCAUSESOFVENOUSTHROMBOSISAREINCOMPLETEDEBRIDEMENTOFBLOODVESSELS,POORQUALITYOFVASCULARANASTOMOSIS,LITTLEAMOUNTOFVEINREPAIRORSUTUREOFTIGHTSKINCLINICALMANIFESTATIONSREFERSTOTHEBODYBYREDTOPURPLEORDARKRED,REFERSTOTHETEMPERATUREDROP,CAPILLARYBACKFILLINGPHENOMENONDISAPPEARED,FINGERTENSIONINCREASED,FINGERLATERALINCISIONFIRSTOUTOFDARKPURPLEBLOOD,AFTERTHEOUTFLOWOFBRIGHTREDBLOODAFTERTHEVEINEMBOLISMOCCURS,ACCORDINGTOTHESEVEREDFINGERCAUSEOFINJURYANDTHEBROKENPLACE,USESTHEDIFFERENTPROCESSINGMETHODALLOFTHEMIDDLEANDMIDDLESEGMENTOFFINGERWERENEARLYSEVEREDFROMTHESIMPLECUTORCHAINSAWINJURY,ANDVENOUSTHROMBOSISOCCURREDWITHIN3DAYSAFTEROPERATIONLOCALINFECTIONWASNOTOBVIOUSANDSHOULDBEEXAMINEDBYOPERATIONWHEREACRUSHOFSTRANGULATED,LOCALINFECTIONORPOSTOPERATIVEVENOUSTHROMBOEMBOLISMOCCURREDABOVE5D,CANBEUSEDTOENDTHELATERALINCISIONONBLOODINJECTIONOFHEPARIN,TOKEEPTHEFINGERBLOODCIRCULATIONBALANCE,SOASTOESTABLISHVENOUSCOLLATERALCIRCULATION3,TREATMENT31“THREEANTI“APPLICATION1ANTIINFECTIONINADDITIONTORELYINGONOFSTRICTDEBRIDEMENT,ROUTINEUSEOFANTIBIOTICSTOPREVENTPOSTOPERATIVEINFECTION,THEDRUGTYPEANDROUTEOFADMINISTRATIONSHOULDBESELECTEDACCORDINGTOTHESEVERITYOFCONTUSIONANDTHEDEGREEOFPOLLUTIONTOTHEORGANIZATIONFORPATIENTSWITHLARGELIMBANDMULTIFINGERAMPUTATIONANDSEVERECONTAMINATION,BROADSPECTRUMANTIBIOTICSWEREUSED,ANDTHEBACTERIALCULTUREANDDRUGSENSITIVITYTESTSOFWOUNDEXUDATESWEREPERFORMEDINPARALLEL,ANDEFFECTIVEDRUGTHERAPYWASAPPLIEDTRYTOAVOIDTHEUSEOFERYTHROMYCINANDOTHERBLOODVESSELSANDGASTROINTESTINALSTIMULATIONOFANTIBIOTICS,ANDPAYATTENTIONTOTHELIVERANDKIDNEYFUNCTIONDAMAGE2ANTICOAGULANTTHERAPYAFTEROPERATIONTOREDUCETHEVARIOUSFACTORSONVASCULARSTIMULATIONANDEFFECT,AVOIDANDPREVENTVASCULARSPASMANDEMBOLISM,MAINTAINTHEPATENCY,ROUTINEUSEOFANTICOAGULATIONANDANTISPASMODICDRUGSFROM7TO10DAYSALOWMOLECULARDEXTRAN40ARELATIVEMOLECULARMASSOF20THOUSAND40THOUSAND,ADEPOLYMERIZATIONANTICOAGULANTANDAPLASMAEXTENDERTHECHARGECANCHANGETHEREDBLOODCELLSANDWHITEBLOODCELLS,TOPREVENTEACHOTHERMUTUALLYEXCLUSIVE,REDBLOODCELLAGGREGATION,REDUCETHEADHESIONOFREDBLOODCELLSANDVASCULARWALL,INHIBITINGPLATELETAGGREGATIONANDRELEASEOFPLATELETFACTORTHIRD,HAVEACERTAINEFFECTONACTIVATIONOFFIBRINOLYSISSYSTEMITCANINCREASECOLLOIDOSMOTICPRESSURE,INCREASEBLOODVOLUME,LOWERBLOODVISCOSITYANDINCREASEBLOODFLOWVELOCITYUSAGE500MLINTRAVENOUSDRIP,Q12H,710DAYSWITHDRAWAL,CHILDRENWEIGHTACCORDINGTOMEDICATIONBHEPARININVOLVEDINPREVENTINGPLATELETAGGREGATIONANDDESTRUCTION,HINDERINGTHEFORMATIONOFTHROMBINENZYMES,PREVENTINGPROTHROMBINFROMBECOMINGTHROMBIN,INHIBITINGTHROMBIN,ANDTHUSPREVENTINGFIBRINOGENFROMBECOMINGFIBRINUSAGE12500UADD09NS500ML24H,SLOWINTRAVENOUSDRIP,7D10DWITHDRAWALCASPIRINCANINHIBITTHEFORMATIONOFPROTHROMBININLIVER,REDUCETHECONTENTOFPROTHROMBININBLOOD,INHIBITPLATELETAGGREGATIONANDREDUCETHEAGGREGATIONOFBLOODCELLS,THUSIMPROVINGMICROCIRCULATIONUSAGEADULT75MG,QN,ORAL,7D10DWITHDRAWALDPAPAVERINERELIEVINGSPASMOFSMOOTHMUSCLEFUNCTIONDIRECTIONS30MG,Q6H,IM,7D10DWITHDRAWALEDIRECTRELAXATIONOFVASCULARSMOOTHMUSCLE,DILATINGPERIPHERALVESSELSANDINCREASINGPERIPHERALBLOODVOLUMEDIRECTIONS25MG,Q6H,IM,7D10DWITHDRAWAL32AFTERTREATMENTANDOBSERVATION1ANTIBIOTICSOBSERVETHEHEALINGOFINCISION,ANDEVALUATETHEEFFECTOFANTIBIOTICSACCORDINGTOTHERESULTOFWOUNDSURFACECULTURE2ANTICOAGULANTDRUGSTHEUSEOFSUCHDRUGS,PRONETOADVERSEREACTIONSSUCHASBLEEDING,WOUNDBLEEDING,SUBCUTANEOUSHEMATOMA,EPISTAXIS,HEMORRHAGE,CONGESTIONANDECCHYMOSISPREVENTIONOFSERIOUSADVERSEREACTIONSSHOULDBETIMELYEXAMINATION,EXAMINATIONOFBLOODROUTINEANDCOAGULATIONFOURITEMS,WHETHERWITHINTHENORMALRANGEGENERALMAYPERMITFOURITEMSOFBLOODCOAGULATION,THERESULTISSLIGHTLYHIGHERTHANNORMAL,BUTNOTHIGHERTHANNORMALTWOTIMESWHENTHEVOLUMEOFBLOODISINSUFFICIENTORANEMIA,BLOODTRANSFUSIONSHOULDBECONSIDEREDTOENSURETHATTHEWHOLEBLOODFLOWINCASEOFBLEEDING,THEDRUGSHOULDBEREDUCEDORDISCONTINUED,ANDNOVASOCONSTRICTORDRUGS,SUCHASNOREPINEPHRINE,SHOULDBEUSEDTOPREVENTVASOSPASMUSECOLDCOMPRESSTHERAPY,WHENSEVERECANBENEUTRALIZEDBYPROTAMINE4,AFTERTHETREATMENTOFSYMPTOMATICANESTHESIA,THEANESTHETICEFFECTOFREPLANTATIONWILLDISAPPEARANDTHEVASCULARSPASMCAUSEDBYTHEPAININDUCEDVASOSPASMSHOULDBEAPPLIEDPROMPTLYANDTHESEDATIVEDRUGSSHOULDBEAPPLIEDINTIMEDUETOTHEBEDCAUSEDBYABDOMINALBLOATINGANDNAUSEA,CONSTIPATIONCANBESYMPTOMATICAPPLICATIONOFHOTCOMPRESS,MASSAGEANDGIVELAXATIVEDRUGS5、PSYCHOLOGICALNURSINGCLINICALOBSERVATIONCONFIRMEDTHATTHEPATIENTSPSYCHOLOGICALREACTIONANDEMOTIONALCHANGESARECLOSELYRELATEDTOTHESURVIVALRATEOFREPLANTATIONSUCHPATIENTSAREMOSTLYYOUNGADULTSS