经皮椎间孔镜治疗腰椎间盘突出症围手术期的护理  

Perioperative care of patients undergoing percutaneous transforaminal endoscopic discectomy

作　　者：杨艳 孙赟 李蕊 杨芳 杨巧惠 薛为高 卞娜[2] 马琼[2] 韩康[2,3] 

机构地区：[1]武警陕西省总队医院骨科,陕西西安710054 [2]第四军医大学唐都医院骨科,陕西西安710038 [3]济南军区总医院脊髓修复科,山东济南250000

出　　处：《中华全科医学》2016年第2期317-319,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(81201633)

摘　　要：目的总结和记录经皮椎间孔镜治疗腰椎间盘突出症患者围手术期的护理方法、特点和护理注意事项。方法对2011年1月—2014年1月住院且明确诊断为腰椎间盘突出症的182例行经皮椎间孔镜治疗的患者临床资料及护理方法进行回顾性分析。在术前、术中、术后,分别就心理护理、辐射防护、功能锻炼等方面进行系统化的综合护理。对其疼痛、焦虑、生活质量改善等指标进行观察和比较。结果所有患者均至少随访至术后6个月;182例患者中,168例患者术后恢复良好,2例出现切口感染,9例出现术后复发,1例出现神经损伤,2例出现脊柱不稳。患者术后的疼痛指标(2.82±0.86)及焦虑指标(38.15±8.0)较前(6.81±1.03;59.45±6.6)均有明显改善(P<0.01)。而在生存质量方面,在生理功能等8项指标中,术后较术前均有明确统计学的改善。结论正确有效的围手术期护理可以使经皮椎间孔镜治疗腰椎间盘突出症患者获得良好的效果,特别是在手术前后的心理护理、术中辐射防护及术后的病情观察及功能锻炼等方面应在临床工作中进一步的推广和应用。Objective To observe and summarize nursing methods,characteristics and matters of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy. Methods The clinical data and nursing methods were retrospectively analyzed of the 182 cases of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy from January 2011 to January 2014. The pain, anxiety and the quality of life improved were observed and compared. In the preoperative, intraoperative and postoperative,respectively,psychological nursing, radiation protection and functional exercise were given. Results The group of 182 patients, 168 patients recovered well after surgery, and 2 patients with infection of incision,9 patients with postoperative recurrence, 1 patient with nerve damage,2 patients with spinal instability. Patients with postoperative pain index （ 2.82 ±0. 86 ） and anxiety index （ 38.15 ± 8.00 ） were improved significantly compared with the previous （ 6.81 ± 1.03 ; 59.45 ± 6.60 ）, P 〈 0.01. In terms of quality of survival, in eight indexes such as physiological function, there were clear improved after operation. Conclusion Correct and effective perioperafive care such as psychological nursing,radiation protection and functional exercise play a significant role in the treatment process of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy which should be further promoted and used in clinical work.

关 键 词：腰椎间盘突出 椎间孔镜 围手术期 

分 类 号：R473.6[医药卫生—护理学] R681.53[医药卫生—临床医学]