后路经椎弓根截骨治疗胸腰椎创伤性后凸畸形的围手术期护理.docVIP

精品论文 参考文献 后路经椎弓根截骨治疗胸腰椎创伤性后凸畸形的围手术期护理 解放军第一七五医院/厦门大学附属东南医院 福建漳州 363000 摘要：目的 探讨后路经椎弓根截骨治疗胸腰椎创伤性后凸畸形的围手术期护理。方法 对18例胸腰椎创伤性后凸畸形行后路经椎弓根椎体楔形截骨矫形手术治疗的患者进行全面、个体化的护理及康复指导。结果 18例患者安全度过围手术期，无护理并发症发生。出院后均获随访，时间24～62（47.7 plusmn;9.5）个月。神经损伤ASIA 评分：术前为25～44（ 34.6 plusmn; 7.2）分，末次随访时为35～50（ 47.7 plusmn; 9.5）分，较术前平均提高13.1分plusmn;3.1分。椎体后凸Cobb 角：术前为21deg;～ 35deg;（ 27.89deg;plusmn; 4.63deg;），术后为2deg;～ 8deg;（ 4.13deg;plusmn; 0.87deg;），较术前平均改善23.7deg;plusmn; 3.3deg;。结论 对后路经椎弓根截骨治疗胸腰椎创伤性后凸畸形患者围手术期进行系统的护理，能减少患者术后并发症的发生，是保证手术治疗效果及提高患者生活质量的重要保障。 关键词：胸腰椎骨折；截骨术；脊柱后凸畸形；围手术期护理 [Abstract] Objective To investigate the perioperative nursing care of thoracic and lumbar vertebrae traumatic posterior convex deformity treated by posterior approach. Methods a total of 18 patients with traumatic posterior deformity of the thoracolumbar spine were treated with pedicle screw fixation，and the nursing care and rehabilitation guidance were carried out. Results 18 cases of patients safely through perioperative period，no nursing complications occurred. All patients were followed up for 24 to 62（47.7 + 9.5）months after discharge. ASIA score of nerve injury：preoperative 25 to 44（34.6 + 7.2）points，the last follow-up was 35 to 50（47.7 + 9.5）points，compared with the preoperative average increase of 13.1 points 3.1 points. Cobb angle of the posterior vertebral body：21 degrees to 35 degrees 4.63 degrees（27.89 degrees），2 degrees to 8 degrees（4.13 degrees），compared with the preoperative average improvement of 23.7 degrees + 3.3 degrees. conclusion of posterior transpedicular osteotomy treating traumatic thoracolumbar kyphosis in patients with peri operative nursing can reduce the incidence of postoperative complications and ensure the effect of surgical treatment and increase the important guarantee of the quality of life of the patients. [Keywords] thoracolumbar fractures；osteotomy；kyphosis；perioperative nursing 脊柱骨折约90%发生在胸腰段，不恰当的非手术治疗由于骨折椎体塌陷，从而导致后凸畸形及神经压迫。胸腰椎创伤性后凸畸形合并神经损伤保守治疗效果差［1］，多需进行手术治疗，围手术期护