腰椎椎间植骨融合术后早期下床活动时机研究  

Research on Early Ambulation Time in Post-operation Patients with Posterior Lumbar Interbody Fusion

作　　者：戴晓洁[1] 孙光霞[2] DAI Xiaojie;SUN Guangxia(Depatment of Orthopaedic,Changzheng hospital affiliated to Naval Medi cal University,Shanghai 200003,China;Department of Nursing,Changzheng hospital affiliated to Naval Medical University)

机构地区：[1]第二军医大学长征医院骨科7楼,上海200003 [2]第二军医大学长征医院护理部,上海200003

出　　处：《解放军护理杂志》2018年第17期64-67,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金面上项目(81572194)

摘　　要：目的探索腰椎椎间植骨融合术后早期下床活动时机对术后康复效果和并发症发生率的影响。方法便利抽样法选取某院2016年7月至2017年12月腰椎融合手术425例患者,按随机数字表法分为观察组195例和对照组230例。观察组患者术后3d拔出引流管及尿管后佩戴围腰下床活动;对照组术后3d拔除引流管,术后14d伤口拆线后佩戴围腰下床活动。观察两组患者住院期间大小便相关并发症、压疮发生率、疼痛、手术切口并发症(裂开、延迟愈合、感染)、内固定物并发症及护理满意度等指标的差异,并进行统计学分析。结果观察组患者术后大小便相关并发症发生率、压疮发生率低于对照组患者,观察组患者疼痛评分及患者满意度高于对照组患者,差异均有统计学意义(均P<0.05);两组患者术后切口并发症发生率、内固定物相关并发症差异无统计学意义(均P>0.05)。结论术后3d下床活动可显著降低腹胀、便秘、膀胱胀痛、尿路感染、压疮等风险,提高满患者满意度,有临床推广价值。Objective To explore the effect of the early ambulant time after posterior lumbar Interbodyfu sion surgery on postoperative rehabilitation and complication rate. Methods By convenience sampling,425 cases received spine surgery from July 2016 to December 2017 were selected. They were divided into obser vation group （195 cases） and control group （230 cases） by the random number table method. In the obser vation group,the drainage tube and Foley catheter were removed 3 days after surgery, and patients wore the waist to get out of bed. In the control group, the drainage tube was removed at 3 d after operation,and 14 d after the wound was removed,the waist was removed from the bed. In the control group, the drainage tube was removed at 3 days after operation, and patients wore the waist to get out of bed at 14 days after removing the suture. The urine and bowel movement related complications, pressure sore incidence, pain, surgical incision complications （cracking, delayed healing, infection）, internal fixation complications and satisfaction were observed and statistically analyzed. Results The incidence of urine and bowel movement related complications and pressure sores in the observation group were lower than those in the control group,and the pain score and satisfaction rate of the observation group were higher than those in the con trol group （all P〈0.05）. There was no significant difference in the incidence of incision complications and fixation related complications between the two groups （all P〉0.05）. Conclusions Getting out of bed at three days after operation can significantly reduce the risk of abdominal distention, constipation, bladder pain, urinary tract infection, pressure sore, and improve the satisfaction of patients ,which is worthy of clini cal promotion.

关 键 词：腰椎融合术 早期下床活动 护理 

分 类 号：R173.59[医药卫生—妇幼卫生保健]