侧俯卧位MRI引导腰脊神经后根神经节射频消融术的手术体位护理  

Surgical position nursing for radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone po

作　　者：黄蘋 董春英 黄立荣 高希春 HUANG Pin;DONG Chunying;HUANG Lirong;GAO Xichun(Mini-invasive operating room with MRI,Liwan Central Hospital of Guangzhou,Guangzhou 510170,China)

机构地区：[1]广州市荔湾中心医院MRI导航微创治疗室,广东广州510170

出　　处：《广州医药》2024年第5期562-566,共5页Guangzhou Medical Journal

摘　　要：目的分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组:侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30°的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间(60.65±12.45)min,俯卧位组手术时间(70.58±10.25)min,组间比较差异有统计学意义(t=3.429,P=0.001)。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义(χ^(2)=4.292,P=0.038)。结论侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position.Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups(the lateral prone position group and the prone position group,31 patients in each group).The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation.Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups.Results All patients completed the operation successfully.No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups.No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either.The operation time was(60.65±12.45)min in the lateral prone position group and(70.58±10.25)min in the standard prone position group,respectively,and the difference was statistically significant(t=3.429,P=0.001).The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group(93.55%)compared with the standard prone position group(77.42%),and the difference was statistically significant(χ^(2)=4.29,P=0.038).Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective.Good surgical position nursing can effectively prevent complications.

关 键 词：手术体位护理 侧俯卧位 射频消融 核磁共振 脊神经后根神经节 

分 类 号：R473.6[医药卫生—护理学]