经皮椎体成形术治疗脊柱压缩性骨折的手术体位改进  

Surgical posture improvement of percutaneous vertebroplasty in the treatment of vertebral compression fractures

作　　者：潘丽芬[1] 刘婉玲[1] 张春燕[1] 谭淑芳[1] 

机构地区：[1]中山大学附属第二医院手术室,广州市510120

出　　处：《中华护理杂志》2010年第7期605-607,共3页Chinese Journal of Nursing

摘　　要：目的探讨经皮椎体成形术(PVP)治疗骨质疏松性脊柱压缩性骨折的手术体位改进方法,评价改进后的手术体位对椎体复位及减少手术并发症的作用和效果。方法将68例患者按手术日期单双数分为试验组(34例40椎)和对照组(34例36椎),试验组按改进后的过伸体位方法,对照组按常规托架俯卧位方法。分别观察、比较两组患者摆放体位后压缩骨折椎体高度和后凸畸形角度的恢复情况、术后疼痛视觉模拟评分(VAS)、并发症的发生等手术效果评价指标。结果试验组在摆放体位后可达到较大程度的椎体复位,椎体高度恢复率(40.1±23.5)%,后凸Cobb's角恢复率(42.5±29.3)%,术后未发生骨水泥渗漏、神经根损伤或其他并发症,与对照组比较,差异有统计学意义(P<0.05)。两组患者术后VAS差异无统计学意义,但对照组部分患者临床主诉腰背部弥漫性疼痛的缓解不明显。结论 PVP是治疗脊柱压缩性骨折的一种脊柱微创技术,采用过伸体位优于常规托架俯卧位。手术室护士应掌握该体位摆放的要点,以保障其安全性和有效性。Objective To evaluate the effect of the improved surgical posture of percutaneous vertebroplasty （PVP） in the treatment of osteoporotic vertebral compression fractures. Methods Totally 68 patients （76 vertebras） were randomly divided into experimental group （over-extending position） and control group （routine prone position）. The ratio of vertebral height loss restored,the ratio of kyphotic angle restored,postoperative pain rated by Visual Analogue Scales（VAS） and postoperative complications were compared between the two groups. Results Compared with the control group,the ratio of vertebral height loss restored,（40.1±23.5）%,and ratio of kyphotic angle restored,（42.5±29.3）%,were significantly higher in the experimental group （P0.05）. The VAS score was lower in the experimental group than in the control group without statistic significance. There were no postoperative complications such as cement leakage and nerve root injury in the experimental group. Conclusion PVP is a kind of minimally invasive technique in the treatment of osteoporotic vertebral compression fractures. Over-extending position is more suitable than routine prone position for PVP. The operating room nurses should grasp the key points of the position to ensure the security and efficacy.

关 键 词：脊柱骨折 骨折 压缩性 椎体成形术 体位 

分 类 号：R687.3[医药卫生—骨科学]