重度颈椎后凸畸形病人平衡悬吊牵引的护理  

Nursing Care of Severe Cervical Kyphosis Patients with Balanced Suspension Traction

作　　者：朱曼 王丹[1] 周非非[1] 马雯 高嘉敏 金姬延[1] ZHU Man;WANG Dan;ZHOU Fei-fei;MA Wen;GAO Jia-min;JIN Ji-yan(Department of Orthopaedics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院骨科,北京100191

出　　处：《骨科》2021年第4期366-369,共4页ORTHOPAEDICS

摘　　要：目的总结重度颈椎后凸畸形病人平衡悬吊牵引的护理措施,探讨平衡悬吊牵引的护理经验与体会。方法回顾性分析2017年3月至2020年7月,术前接受平衡悬吊牵引预矫形的17例重度颈椎后凸畸形病人的临床资料。牵引过程中,对病人采取不良反应的观察与处理、平衡悬吊牵引管理、心理疏导和舒适护理等系统的护理干预措施。观察病人牵引前后后凸Cobb角、颈椎功能障碍指数(NDI)、日本骨科协会(JOA)评分改善情况和牵引期间不良反应发生情况。结果本组病人顺利完成平衡悬吊牵引,牵引时间为(8.6±7.1)d;牵引前后凸Cobb角为82.5°±39.9°,牵引后后凸Cobb角为41.9°±24.4°,差异有统计学意义(P<0.05),后凸矫正率为50.6%±14.9%;牵引前后的NDI(7.1%±4.3%vs.6.2%±8.0%)和JOA评分[(15.5±4.2)分vs.(16.1±3.8)分]比较,差异均无统计学意义(P均>0.05)。牵引过程中,出现重症不良反应1例,轻症不良反应6例,经护理干预后缓解。结论平衡悬吊牵引可有效地改善重度颈椎后凸畸形病人的颈椎后凸角度,通过系统地护理干预,可以保证牵引安全,改善病人不良反应,提高牵引有效性。Objective To summarize the nursing measures of balanced suspension traction in patients with severe cervical kyphosis,and explore the nursing experience.Methods From March 2017 to July 2020,17 patients with severe cervical kyphosis who received balanced suspension traction were retrospectively analyzed.The cases were all given nursing measures such as neurological symptoms observation,balanced suspension traction management,psychological counseling and comfortable nursing.The kyphosis Cobb angle,neck disability index(NDI),Japanese Orthopaedic Association(JOA)score and adverse reactions during traction were observed.Results The patients successfully completed the balanced suspension traction,and the traction time was(8.6±7.1)d.The Cobb angle was 82.5°±39.9°before traction and 41.9°±24.4°after traction,the difference was statistically significant(P<0.05).The kyphosis correction rate was 50.6%±14.9%.There was no significant difference in NDI(7.1%±4.3%vs.6.2%±8.0%)and JOA score(15.5±4.2 vs.16.1±3.8)before and after traction(all P>0.05).In the process of traction,1 case had severe adverse reactions and 6 cases had mild adverse reactions,which were relieved after nursing intervention.Conclusion Balanced suspension traction can effectively improve the cervical kyphosis angle of patients with severe cervical kyphosis deformity.Through systematic nursing intervention,it can ensure the safety of traction,improve the adverse reactions of patients,and improve the effectiveness of traction.

关 键 词：平衡悬吊牵引 重度颈椎后凸畸形 护理 

分 类 号：R473.6[医药卫生—护理学]