微创经皮椎弓根螺钉内固定治疗胸腰椎骨折临床疗效及手术配合  

Mini-invasive percutaneous pedicle screw fixation and nursing in thoracolumbar fracture

作　　者：鲁华[1] 石亚灵[1] 代群[1] 陈杰[1] 

机构地区：[1]四川省医学科学院.四川省人民医院手术室,四川成都610072

出　　处：《实用医院临床杂志》2011年第5期57-59,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨微创经皮椎弓根螺钉Sextant系统内固定治疗胸腰椎骨折的手术效果及术中护理配合。方法 2008年10月至2010年10月我院收治33例胸腰椎单节段骨折患者,其中微创经皮椎弓根螺钉内固定治疗(微创手术组)21例,常规开放式椎弓根螺钉内固定治疗(开放手术组)12例。比较两组切口大小、术中出血量、手术时间、后凸畸形矫正情况,以及手术室护士对患者的术前心理护理及物品准备,总结术中配合。结果与开放手术组比较,微创手术组的手术切口小,术中出血量及术后引流量明显减少,手术时间明显缩短,术后Cobb角矫正、矢状径、骨折椎体的前柱高度显著改善,差异均有统计学意义(P<0.05);手术室护士充分的术前准备、积极的术中配合,确保了手术的顺利实施。结论 对手术指针充分的胸腰椎骨折患者,使用Sextant系统微创经皮椎弓根螺钉内固定治疗是一种较好的治疗选择,手术护理配合对手术的成功起重要作用;应特别注意患者体位、器械准备、无菌管理和放射保护。Objective To assess the effect of mini-invasive percutaneous pedicle screw fixation and the role of nursing in thoracolumbar fracture using Sextant system.Methods From October 2008 to October 2010,33 single segment thoracolumbar fracture patients in our department were selected.They were divided into 2 groups.Twenty-one cases were included in the Sextant percutaneous pedicle screw fixation group and 12 cases were in the open pedicle screw fixation group.The incision size,surgical time,surgical blood loss and correction rate of kyphosis between the two groups were compared.And preoperative psychological care for patients and intraoperative preparation by operating room nurses were summarized.Results Compared with the open pedicle screw fixation group,patients in the Sextant percutaneous pedicle screw fixation group had significant smaller incision size,less surgical blood loss and post-operative drainage,and shorter surgical time（P0.05）.There were significant postoperative improvement in Cobb＇s angle,sagittal diameter and anterior column height of fracture vertebral body between the two groups（P0.05）.Sufficient preoperative preparation and intraoperative actively cooperation of operating room nurses ensured the smooth implementation of the operation.Conclusions With good surgical indications,percutaneous pedicle screw fixation using Sextant system is a good therapeutic choice for patients with thoracolumbar fracture.Nursing cooperation in operation room plays an important role for the success of the minimal invasive spinal surgery.Special attention should be paid on patients＇ position,instrument arrangement,asepsis management and radiation shield.

关 键 词：椎弓根螺钉 内固定 胸椎骨折 腰椎骨折 护理 

分 类 号：R683.2[医药卫生—骨科学] R472.3[医药卫生—外科学]