32例颈椎术后患者早期神经功能恶化的观察和护理

Nursing care of 32 patients with early neurological deterioration after cervical vertebrae operation

总结了32例颈椎术后早期神经功能恶化患者的临床护理经验。护理措施包括正确的术前评估、病情的正确判断、正确的给药护理、正确的心理护理与康复训练指导。7例四肢瘫合并呼吸功能障碍者,除1例抢救无效死亡外,其余6例行血肿清除术后症状即刻缓解。另外25例神经症状加重不伴有明显呼吸困难的患者中,15例行原入路探查、血肿清除术或择期二期手术后,症状即刻或逐渐改善;10例未再次手术患者经高压氧治疗后症状不同程度改善。随访6个月,采用日本矫形外科协会(JOA)评分,平均9分。采取积极有效的护理措施可以及时发现早期神经功能恶化,降低致残率,促进患者康复。

This paper summarizes the nursing experience on 32 patients with early neurological deterioration after cervical vertebrae operation.Nursing care focused on proper preoperative evaluation,judgement of patient condition,medication administration,psychological nursing and rehabilitation training instruction.Among 7 tetraplegia patients combined with respiratory dysfunction,a patient died and the other 6 patients relieved immediately after hematoma clearance.The other 25 patients without severe respiratory dysfunction relieved after exploratory operation,hematoma clearance or selective secondary operation,or hyperbaric oxygen therapy.The mean JOA score for these patients 6 months after discharge was 9.It is suggested that effective nursing care can detect early neurological deterioration timely,reduce the rate of disability and promote patients＇ recovery.