脊柱微创经皮椎间孔镜日间手术全程化管理模式的构建与效果评价  

Construction and Effect Assessment of Whole Course Management Mode in Spine Inimally Invasive Percutaneous Intervertebral Foramen Mirror Ambulatory Surgery

作　　者：韩杰 付玲玲[1] 程素洁 Han Jie;Fu Lingling;Cheng Sujie(Qilu Hospital of Shandong University,Jinan Shandong 250012,China)

机构地区：[1]山东大学齐鲁医院山东大学护理理论与实践创新研究中心,山东济南250012 [2]潍坊市益都中心医院

出　　处：《齐鲁护理杂志》2022年第2期11-14,共4页Journal of Qilu Nursing

摘　　要：目的:探讨脊柱微创经皮椎间孔镜日间手术全程化管理模式的构建与效果。方法:选取2017年3月1日~2018年3月31日行经皮椎间孔镜下髓核摘除术的94例腰椎间盘突出症患者作为对照组,采取常规住院管理模式。选取2018年4月1日~2019年4月30日行经皮椎间孔镜下髓核摘除术日间手术的88例腰椎间盘突出症患者作为日间组,实施涵盖门诊、病房、出院后随访的全程化日间手术管理模式。比较两组临床效果。结果:两组患者术后各期视觉模拟评分法(VAS)、JOA、ODI评分较术前改善(P<0.05),两组术后各期VAS、JOA、ODI评分及并发症发生率比较差异无统计学意义(P>0.05)。日间组术前等待时间、住院时间、直接医疗费用低于对照组(P<0.01),患者满意度高于对照组(P<0.05)。结论:经皮椎间孔镜日间手术全程化管理模式应用于腰椎间盘突出症患者临床疗效较好,具有可行性、安全性、有效性,同时在提高医疗资源的利用率、降低住院费用方面具有明显优势。Objective:To explore the construction and effect of whole course management mode in spine inimally invasive percutaneous intervertebral foramen mirror ambulatory surgery.Methods:A total of 94 cases of lumbar intervertebral disc protrusion patients who inderwent intervertebral foramen microscopical excision of nucleus pulposus during March 1,2017 to March 31,2018 were selected as the control group,and were given normal hospital management mode.88 cases of lumbar intervertebral disc protrusion patients who underwent intervertebral foramen microscopicall excision of nucleus pulposus ambulatory surgery during April 1,2018 to April 30,2019,88 cases of lumbar intervertebral disc protrusion were selected as the ambulatory group,and were given the whole course ambulatory surgery management mode during outpatient,ward and follow-up after discharge.Comparison was made between the two groups on clinical effect.Results:The visual analogue scale(VAS),JOA and ODI scores in both groups of patients during postoperative periods were higher than those in preoperative periods(P<0.05),There were no significant differenxes in VAS,JOA,ODI scores and complication rates between both groups in postoperative periods(P>0.05).The preoperative waiting f time,length of hospital stay,and the direct medical costs were lower in the ambulatory group than those in the control group(P<0.01),and the patient satisfaction was higher in the ambulatory group than that in the control group(P<0.05).Conclusion:Application of whole course management mode of percutaneous intervertebral foramen mirror ambulatory surgery in patients with lumbar disc prolapse has good clinical curative effect,with good feasibility,safety and effectiveness,at the same time has significant advantages in improving the utilization of medical resources,and reducing hospitalization cost.

关 键 词：经皮椎间孔镜 髓核摘除术 腰椎间盘突出症 日间手术 全程化管理 

分 类 号：R473.6[医药卫生—护理学]