椎体骨折不愈合微创治疗围手术期管理

Perioperative management of minimal invasive treatment for vertebral compression fracture nonunion

目的探讨椎体骨折不愈合微创治疗的围手术期干预要点。方法采用经皮球囊扩张椎体后凸成形术(PKP)治疗36例椎体骨折不愈合患者,对其实施个体化围手术期干预措施,包括术前病情评估、体位训练,心理疏导,术后密切病情观察,康复训练,抗骨质疏松治疗及出院指导等。结果PKP术镇痛效果满意,术后48小时患者即可佩戴腰围固定带或支具离床活动,生活质量得到显著提高,自理能力也较术前有显著改善。疼痛缓解率和功能改善率达95%。结论细致周密的围手术期管理方案对于椎体骨折不愈合微创治疗取得满意疗效至关重要。

Objective To explore the key points of perioperative intervention points of minimal invasive treatment for vertebral compression fracture nonunion. Methods A series of perioperative intervention, including preoperative condition assessment, postural training, psychological counseling, postoperative condition observation, rehabilitation training, anti-osteoporosis treatment, and discharge guidance, were provided for 36 patients with vertebral compression fracture nonunion, who received percutaneous kyphoplasty （PKP） from June 2009 to December 2011. Results The analgesic effect after PKP was satisfactory. Patients wearing waist belt could get off bed in 48 hours after the operation. The quality of life and self-care ability improved significantly compared with that in preoperative period. Pain relief rate and functional improvement rate were 95%. Conclusion Meticulous and thorough perioperative intervention is essential to achieve satisfactory recovery after the minimal invasive treatment for vertebral compression fracture nonunion.