全程无缝链接护理与常规护理在强直性脊柱炎后凸畸形合并颈椎骨折围术期的应用效果比较  

Comparison of application effect of whole-process seamless nursing and conventional nursing in the perioperative period of ankylosing spondylitis with kyphosis complicated by cervical spine fracture

作　　者：苏豫囡 李方方 赵红玉 张新艳 高延征 Su Yunan;Li Fangfang;Zhao Hongyu;Zhang Xinyan;Gao Yanzheng(Department of Spine and Spinal Cord Surgery,Henan Provincial People′s Hospital,Henan Provincial Key Laboratory of Nursing,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院脊柱脊髓外科,河南省护理医学重点实验室,郑州大学人民医院,郑州450003

出　　处：《中华创伤杂志》2023年第12期1101-1108,共8页Chinese Journal of Trauma

摘　　要：目的比较全程无缝链接护理与常规护理在强直性脊柱炎(AS)后凸畸形合并颈椎骨折围术期的应用效果。方法采用回顾性队列研究分析2017年4月至2022年12月河南省人民医院收治的64例AS后凸畸形合并颈椎骨折患者的临床资料,其中男37例,女27例;年龄27~73岁[(49.8±14.6)岁]。骨折部位:椎体骨折43例,椎间隙骨折21例。患者均行复位固定术或矫形固定术。2017年4月至2019年8月入院的32例采用常规护理(常规护理组),2019年9月至2022年12月入院的32例采用全程无缝链接护理(无缝链接护理组)。比较两组术前,术后12 h、24 h、1个月、3个月及末次随访时视觉模拟评分(VAS);术前,术后1个月、3个月及末次随访时美国脊髓损伤协会(ASIA)分级;术前及末次随访时健康调查简表(SF-36)评分、患者满意度评分;术后并发症发生率。结果患者均获随访6~12个月[(9.8±3.2)个月]。两组术前VAS差异无统计学意义(P>0.05),无缝链接护理组术后12 h、24 h、1个月、3个月及末次随访时VAS分别为(3.9±1.9)分、(4.2±0.7)分、(2.7±0.9)分、(2.6±0.6)分、(1.7±0.8)分,低于常规护理组的(5.7±1.2)分、(5.8±1.1)分、(3.6±1.2)分、(3.2±1.1)分、(2.4±1.0)分(P<0.05或0.01)。无缝链接护理组术后12 h、24 h、1个月、3个月及末次随访时VAS低于术前(P均<0.05),术后1、3个月及末次随访时VAS低于术后12、24 h,且末次随访时VAS低于术后1、3个月(P均<0.05)。常规护理组术后12、24 h与术前VAS比较,差异无统计学意义(P均>0.05),术后1、3个月及末次随访时VAS低于术前和术后12、24 h,且末次随访时VAS低于术后1、3个月(P均<0.05)。两组术后24 h与术后12 h VAS比较、术后3个月与术后1个月VAS比较,差异均无统计学意义(P均>0.05)。两组术前ASIA分级差异无统计学意义(P>0.05);无缝链接护理组术后1个月、3个月及末次随访时ASIA分级较常规护理组显著改善(P<0.05)。两组术前SF-36评分和患Objective To compare the application effect of whole-process seamless nursing and conventional nursing in the perioperative period of ankylosing spondylitis(AS)with kyphosis complicated by cervical spine fracture.Methods A retrospective cohort study was conducted to analyze the clinical data of 64 patients with AS with kyphosis complicated by cervical spine fracture admitted to Henan Provincial People′s Hospital from April 2017 to December 2022,including 37 males and 27 females,aged 27-73 years[(49.8±14.6)years].There were 43 patients with vertebral fractures and 21 with intervertebral space fractures.All patients underwent reduction and fixation or correction and fixation.Thirty-two patients admitted from April 2017 to August 2019 received conventional care(conventional nursing group),and 32 patients admitted from September 2019 to December 2022 received whole-process seamless care(seamless nursing group).The two groups were compared concerning the visual analog scale(VAS)before,at 12 hours,24 hours,1 month,3 months after surgery and at the last follow-up,the American Spinal Injury Association(ASIA)score before surgery,at 1 and 3 months after surgery and at the last follow-up,the health survey questionnaire(SF-36)score and patient satisfaction score before surgery and at the last follow-up,as well as the incidence of postoperative complications.Results All patients were followed up for 6-12 months[(9.8±3.2)months].There was no statistical difference in preoperative VAS between the two groups(P>0.05).The values of VAS in the seamless nursing group were(3.9±1.9)points,(4.2±0.7)points,(2.7±0.9)points,(2.6±0.6)points,and(1.7±0.8)points at 12 hours,24 hours,1 month,3 months after surgery and at the last follow-up,respectively,lower than those of the conventional nursing group[(5.7±1.2)points,(5.8±1.1)points,(3.6±1.2)points,(3.2±1.1)points,and(2.4±1.0)points](P<0.05 or 0.01).The VAS of the seamless nursing group at 12 hours,24 hours,1 month,3 months after surgery and at the last follow-up was lower than

关 键 词：脊柱炎 强直性 脊柱后凸 脊柱骨折 颈椎 护理 

分 类 号：R473.6[医药卫生—护理学]