重度退行性脊柱侧凸患者行分期微创手术的术后护理

Postoperative nursing of patients with severe degenerative scoliosis undergoing staged minimally invasive surgery

总结分期微创手术策略在12例重度退行性脊柱侧凸患者中的护理经验。针对该组患者Ⅰ期术后腰大肌肌力减退、术后疼痛、麻痹性肠梗阻高发、限制性通气障碍等护理问题,采取指导腰大肌肌力锻炼联合微波治疗,遵循定时、定评估工具、动态评估和干预后再评估原则,评估患者疼痛变化,尽早采用三阶梯多模式药物干预;制订和应用个性化运动处方;采用多通道方案预防麻痹性肠梗阻;制订递进式呼吸训练方案;个性化心理护理及合理用药。经过精心治疗与护理,本组患者住院时间10~14 d,均痊愈出院。

To summarize the nursing of staged minimally invasive surgical strategy in 12 patients with severe de-generative scoliosis.Aiming at the problem of psoas muscle strength decline,postoperative pain,high incidence of paralytic intestinal obstruction and restrictive ventilation disorder after stageⅠsurgery in this group of patients,guided psoas muscle strength exercise combined with microwave therapy was adopted.The principles of timing,fixed assessment tools,dynamic assessment and reassessment after intervention were followed to evaluate the pain changes of patients,and three-step multimodal drug intervention was implemented as soon as possible.Personalized exercise prescription was formulate and applied,a multi-channel prevention program was used for preventing paralyt-ic ileus.A progressive breathing training program was developed and individualized psychological nursing and ra-tional medication were used.After careful treatment and nursing,the length of hospital stay was from 10 to 14 days,and all patients were cured and discharged.