摘要
目的探讨经新型Vista可视化通道下微创经肌间隙入路腰椎椎间减压植骨融合内固定术治疗峡部裂性腰椎滑脱的围手术期护理方法。方法回顾性分析作者医院2015-07/2016-06月收治的26例Meyerding分级为Ⅰ~Ⅱ度的峡部裂性腰椎滑脱患者,其中在Vista通道下微创手术治疗12例,传统开放手术14例。术前对患者进行健康评估,重视心理护理,做好健康宣教及术前准备,术后给予病情观察,加强腰腹部手术后的各项护理,合理的功能锻炼指导及训练;记录并比较两组患者术中出血量、术后伤口引流量、术后下地活动时间、术后并发症发生率、术后3天、6月腰腿痛视觉模拟评分(visual analogue scale,VAS)及术后6月Oswestry功能障碍指数(oswestry disabilityindex,ODI)、住院天数等指标。结果微创组在术中出血量、术后伤口引流量、术后下地时间、术后3天腰腿痛VAS评分、住院时间较开放组有明显优势,差异有统计学意义(P<0.05)。两组患者在术后6月腰腿痛VAS评分、ODI指数差异无统计学意义(P>0.05)。功能恢复、症状体征消失24例,约占92.31%;恢复日常生活活动2例,约占7.69%,术后无护理并发症发生。结论 Vista通道下微创治疗峡部裂性腰椎滑脱症与传统手术相比具有相似的远期疗效,做好围手术期的护理工作对于提高手术疗效,减少并发症,缩短患者住院时间,改善患者术后生活质量有重要意义。
Objective To explore the perioperative nursing method of isthmic spondylolisthesis treated with minimally invasive paraspinal muscle approach decompression,fusion and internal fixation under new Vista channel.Methods Twenty-two isthmic spondylolisthesis patients of degree I-II based on Meyerding standard were retrospectively analyzed from July 2015 to June 2016 in authors＇ hospital,including 12 cases of minimally invasive surgery under vista channel,14 cases of traditional open surgery.All patients were received preoperative health assessment,and mental care,health education,preoperative preparation were performed at the same time.The postoperative conditions of illness were observed,and all patients were given waist and abdomen postoperative nursing,reasonable functional guidance and training.The intraoperative blood loss,postoperative wound drainage,walk time,complication rate,3-day and 6-month visual analogue scale（VAS）scores of back and leg pain,6-month Oswestry disability index（ODI）,hospital stays were recorded and compared.Results Compared with the traditional open surgery group,there were obvious advantages on the intraoperative blood loss,postoperative wound drainage,walk time,3-day VAS scores of back and leg pain and hospital stays in the minimally invasive surgery group（P〈0.05）.There was no significantly difference in VAS scores and ODI in 6 months postoperatively between the two groups（P〈0.05）.Lumbar functions were recovered and symptoms or signs disappeared in 24 cases,about 92%.The remaining 2 cases recovered to normal activities,about 8%,and no postoperative nursing complications occurred.Conclusion Comparing with the traditional surgery,the minimally invasive treatment of isthmic spondylolisthesis under Vista channel has similar long-term efficts.The good perioperative nursing can improve the surgical efficacies,reduce the complications,shorten the hospital stays and perfect postoperative life qualities.
出处
《华南国防医学杂志》
CAS
2018年第1期55-57,共3页
Military Medical Journal of South China
基金
湖北省自然科学基金项目(2014CFB473)
