严重脊柱侧凸行Halo-重力牵引过程中的护理问题及护理措施  

Nursing problems in the treatment of Halo-gravity traction for severe scoliosis patients and relevant nursing intervention

作　　者：周媛苑[1] 王倩[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,江苏南京210008

出　　处：《实用临床医药杂志》2011年第18期128-130,共3页Journal of Clinical Medicine in Practice

摘　　要：目的改善严重脊柱侧凸患者在进行Halo-重力牵引治疗过程中的肺功能,减少患者在牵引治疗过程中的各种并发症,提高手术的安全性,使患者顺利度过手术期。方法分析严重脊柱侧凸患者在进行Halo-重力牵引治疗过程中的护理问题,给予呼吸功能训练、体位指导、牵引重量的调节、生活护理以及心理疏导等相应的措施。结果牵引后Cobb角为72°-124°,平均84.8°,矫正率为20%-30%;患者最大肺活量增加至正常预计值的35%以上;血气分析：动脉血氧分压70-88mmHg,动脉二氧化碳分压45-50 mmHg,pH 7.35-7.45,动脉血氧饱和度92%-95%。牵引期间发生轻度臂丛神经损伤者有2例,轻度肠系膜上动脉综合征2例,经过对症治疗后未再出现此类并发症,按时行后路矫形手术。结论通过分析Halo-重力牵引过程中的存在或潜在的护理问题,给予相应的护理干预措施,增加了患者的最大肺活量,并减少了各种并发症,从而提高了手术的安全性,增加了患者对手术效果的满意度,改善了患者的生活质量。Objective To improve severe scoliosis patients＇ pulmonary function in the treatment of Halo-gravity traction,reduce various complications,increase surgery safety and help patients go through perioperative period.Methods Analysis was done to address the nursing problems of severe scoliosis patients during the treatment of Halo-gravity traction.Corresponding measures were provided including respiratory function exercises,position introduction,adjustment of traction weight,life care and psychological counseling.Results The Cobb angle after traction was from 72 to 124 degree（mean 84.8 degree） with correction rate of 20% to 30%.Patients with FVC（VC） increased to 35% of predicted value and blood gas analysis indicated that PaO2 was 70-88 mmHg,PaCO2 45-50 mmHg,pH 7.35-7.45,and SaO2 92%-95%.Two patients had mild brachial plexus damage and 2 had mild superior mesenteric artery syndrome.The complications mentioned above never happen after symptomatic treatment and all patients underwent posterior surgery.Conclusion The pulmonary function of patients improves and complications reduce when the presence or potential nursing problems can be analyzed and corresponding nursing can be offered during the treatment of Halo-gravity traction.Thus operation safety can be increased and patients′ will be more satisfied with surgery and their life quality improves.

关 键 词：严重脊柱侧凸 Halo-重力牵引 护理问题 

分 类 号：R473.6[医药卫生—护理学]