持续质量改进结合循序渐进式措施在颈椎外伤脊髓损伤行前后路联合手术患者中的效果  

Effect of continuous quality improvement combined with step-by-step measures in patients with cervical spinal cord injury undergoing anteri-or and posterior combined surgery

作　　者：彭翠云[1] 马双[1] 肖鹏霞 范晓龙 PENG Cuiyun;MA Shuang;XIAO Pengxia;FAN Xiaolong(Department of Spine Surgery,Sanmenxia Hospital of Yellow River Sanmenxia Henan 472000,China)

机构地区：[1]河南省黄河三门峡医院脊柱外科,河南三门峡472000

出　　处：《中国急救复苏与灾害医学杂志》2021年第7期789-792,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：中国水利水电第十一工程局有限公司科技项目(编号:2016-158)。

摘　　要：目的研究持续质量改进结合循序渐进式措施在颈椎外伤脊髓损伤行前后路联合手术患者中的效果。方法选取2016年2月-2019年12月在河南省黄河三门峡医院就诊的120例颈椎外伤脊髓损伤患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组60例患者。所有患者术后均采取常规护理措施,观察组患者在此基础上联合采用持续质量改进结合循序渐进式措施。比较两组患者术后的疼痛评分、康复指标、生活质量评分、护理满意度。结果两组患者术后的视觉模拟(visual analogue scale/score,VAS)评分均显著升高,且观察组患者术后2、6、12、24 h的VAS评分均显著低于对照组(P<0.05)。观察组的拔除引流时间、自理能力恢复时间以及住院时间显著短于对照组(t=3.456、8.472、12.077,均P<0.05)。两组患者术后的世界卫生组织生存质量测定问卷(WHO-QOL-BREF)评分均显著升高,且观察组患者术后的WHO-QOL-BREF评分显著高于对照组(P<0.05)。观察组患者的护理满意度为95.00%,显著高于对照组的83.33%(χ2=4.232,P=0.039)。结论颈椎外伤脊髓损伤患者在行前后路联合手术治疗中应用持续质量改进结合循序渐进式措施,患者的疼痛感及生活质量显著改善,建议临床推广应用。Objective To study the effect of continuous quality improvement combined with step-by-step measures in patients with cervical spinal cord injury undergoing anterior and posterior combined surgery.Methods 120 pa‐tients with traumatic fracture and dislocation of cervical spine treated in sanmenxia hospital of yellow river from Feb‐ruary 2016 to December 2019 were selected as the study objects,and they were divided into the observation group and the control group according to the principle of random number table,60 patients in each group.All patients took routine nursing measures after operation,on this basis,the patients in the observation group were combined with continuous quality improvement and step-by-step measures.The postoperative pain score,rehabilitation index,quality of life score and nursing satisfaction of the two groups were compared.Results The visual analogue score(VAS)of the two groups after operation were significantly higher,and the VAS scores of the observation group at 2,6,12 and 24 hours after operation were significantly lower than those of the control group respectively(P<0.05).The drainage time,the recovery time of self-care ability and the hospitalization time of the observation group were signif‐icantly lower than those of the control group(t=3.456,8.472,12.077,all P<0.05).The WHO-QOL-BREF score of the two groups after operation was significantly higher,and the WHO-QOL-BREF score of the observation group af‐ter operation was significantly higher than that of the control group(P<0.05).The nursing satisfaction of the observa‐tion group was 95.00%,which was significantly higher than 83.33%of the control group(χ2=4.232,P=0.039).Con⁃clusion Continuous quality improvement combined with step-by-step measures is applied to the patients with cervi‐cal trauma and spinal cord injury,the pain and the quality of life of the patients are significantly improved.It is rec‐ommended to promote the clinical practice.

关 键 词：颈椎外伤脊髓损伤 前后路联合手术 持续质量改进 循序渐进 生活能力 

分 类 号：R473.6[医药卫生—护理学]