In the era of rapid information development, people are dependent on computers and mobile phones for life, entertainment, and work. Currently, the onset of CDH is seriously increasing in the younger population. Changes in the morphological structure of the cervical spine are closely related to body posture in daily life and work. Head, neck, and shoulder activities directly affect the physiological function and morphological degeneration of each cervical segment[20, 21]. Clinical studies have shown that the incidence of CDH is closely related to the internal and external imbalance of the cervical spine. Therefore, the restoration of the dynamic and static balance of the cervical spine is the key to effective treatment and prevention of CDH[22]. During hospitalization and after discharge, the guiding interventions regarding the patient’s functional exercise of the cervical spine can help to achieve a significant clinical effectiveness[21, 23]. After discharge,the patient's compliance decreased or disappeared,and the relief of early symptoms made the patient forget that good work or lifestyle was the basic to maintain the normal function of the cervical spine[24]. Some patients slowly neglect good behavior habits and maintain cervical functional exercise, leading to the recurrence of disease symptoms or adjacent segment disc herniation. This study aimed at patients with cervical disc herniation,through the whole process of integrated management of follow-up evaluation guidance, achieved an ideal clinical management effect.
The conventional nursing management mode leads to the asymmetry of information between medical care, doctor-patient and nurse-patient, and there are a few contradictory and inconsistent aspects[25]. Causes the patient to distrust the doctor and the nurse, even does not cooperate the treatment situation. The whole course integrated management mode is a new type of treatment and rehabilitation management mode which breaks the traditional nursing mode.[12,15]This new model breaks down the previously conservative "subordination model" between medical care, doctor-patient care and nurse-patient care. Management teams are formed by doctors in charge and responsible nurses to participate in the whole process of patients' recovery and nursing during the perioperative period and after discharge[13-15]. As a result, many hospitals have developed a new type of nursing mode, continuous treatment mode, family doctor management mode and participation mode using modern information platform (such as QQ group, WeChat group, etc.) to form a new situation of seamless docking and three-dimensional integration between doctors, nurses and patients[26,27]. The classic procedure for CDH is cervical discectomy, bone graft fusion and internal fixation. However, the long-term clinical follow-up found that the associated complications of approach and the acceleration of degeneration of adjacent segments were the clinical concerned, and the related symptoms and signs of cervical spondylosis appeared again[5-7]. The development of spinal full-endoscopy not only avoided the deficiency of open surgery, but also fully preserve the biomechanical stability of the spine[28,29]. However, patients and non-specialists have little knowledge of modern spine full-endoscopic techniques, they are reluctant to undergo full-endoscopic treatment at an early stage. The patients of CDH who need surgical treatment, due to local disc herniation resulting in limited compression of the spinal cord, percutaneous full-endoscopic surgery not only achieved the purpose of percutaneous targeted removal of disc tissue and spinal decompression, but also reflected the cosmetic effect, reduce the associated open surgical approach complications, better maintain the biomechanical stability of the spine, avoided the acceleration of degeneration in adjacent segments[30,31]. Through the integrated management model,doctors,nurses and patients have a consistent understanding on percutaneous spinal full-endoscopic procedure. Especially through the physician's explanation of the etiology,mechanism,operation,spinal cord nerve function recovery and cervical biomechanical stability. Then, the responsible nurses fully understand and cooperate with the doctor's orders, actively carry out health education and psychological care to the patients, so that the patients from worry,fear to recognize,understand,and voluntary choiced, willing to accept percutaneous full-endoscopic treatment and building confidence.
The results showed that there was no significant difference between the two groups,p >0.05, indicating that the newly developed percutaneous spinal full-endoscopy was effective and feasible.The compliance rate of the experimental group was better than that of the control group. The VAS, JOA scores of postoperative were significantly better than preoperative, p < 0.05. There was no statistically significant difference in JOA and VAS scores between the two groups, p >0.05. integrated management model of the whole course enables CDH patients to receive percutaneous endoscopic treatment and obtained consistent effect with classical surgical procedure, avoided or significantly reduce the complications associated with the approach, improve the patient compliance rate, significantly reduce the length of hospital stay, while reducing the recurrence rate of symptoms[32-34]. Through the integrated management of the whole course,we can promote the consistency of medical and health education,improve the compliance of CDH patients to actively cooperate with treatment,cultivate and maintain good living and working posture, and strengthened awareness of maintaining the health of the cervical spine.[3,14,24]. The establishment of this new health education model of medical cooperation strengthens the sense of responsibility,makes the personnel of each management group attach great importance to and actively participate,ensures the safety of medical treatment and nursing,avoids the occurrence of medical errors and accidents,and improves the satisfaction of clinicians and patients with nursing work[25,26]. It also promotes the development of new medical technology,effectively reduces the average length of hospital stay and speeds up the turnover rate of hospital beds. At the same time,it is beneficial to actively carry out the training and examination of medical staff,promote doctors and nurses to pay attention to the frontier knowledge of specialty,achieve common progress and enhance the construction of subject talents[25,32].
The whole process integrated management model, as a new type of clinical medical cooperation mode, has achieved good clinical results in a certain professional environment. It is restricted by the degree of cooperation and harmony between medical and nursing staff, the training and assessment of medical and nursing staff, the understanding of leadership and the degree of support[32,34]. There is still a longer time to explore the wide application in clinic. At the same time,with the rehabilitation needs of different diseases,for some special patients,the whole process integrated management model can also be extended to cooperate with dietitians,rehabilitators,pharmacists and other multi-professional personnel to discuss and optimize the management plan for the rehabilitation of patients during hospitalization and after discharge[33-35].