颈椎前路减压植骨融合内固定术后窒息的抢救与护理

Rescue and nursing of patients with asphyxia after anterior cervical decompression and fusion with plate fixation

目的 探讨颈椎前路减压植骨融合内固定术后患者发生窒息的抢救护理要点.方法 选取本院收治的226例资料完整的颈椎前路减压植骨融合内固定患者进行总结分析.结果 226例患者手术均顺利完成,X线检查示术后3个月植骨区部分骨性融合,4～5个月完全骨性融合,术后椎间高度未发生丢失现象,生理曲度良好；所有患者均未发生脊髓、血管损伤,无钢板螺钉松动移位、植骨块脱出和颈椎假关节形成.结论 颈椎前路减压植骨融合内固定术是目前治疗颈椎病和颈椎骨折脱位的最有效方法,窒息是手术后发生的危急并发症之一,必须在很短的时间内作出有效处理,否则可出现严重后果,所以第一时间发现患者病情变化并做出有效的抢救处置是挽救患者生命的重要手段.

Objective To discuss main nursing care points for patients who undergo asphyxia after anterior cervical decompression and fusion with plate fixation.Methods The clinical data of 226 fully-documented patients admitted into our hospital from October 2008 to October 2010 for anterior cervical decompression and fusion with plate fixation were summarized and analyzed.Results All patients underwent the surgery successfully.X-ray examination 3 months after the surgery showed partial bony fusion and full bony fusion was observed during the 4th to 5th month.Intervertebral height loss did not occur and physiological curvature was fine after the surgery.None of the patients suffered from spinal cord or blood vessel injuries.No loose or displacement of plate screw,graft bone dislocation or pseudarthrosis formation was found.Conclusion Anterior cervical decompression and fusion with plate fixation is the best treatment for cervical spondylosis and cervical vertebra fractures and dislocations.As one of the critical complications,asphyxia has to be handled within a short time to avoid severe consequences.Thus,it is a vital approach to reduce the occurrence of asphyxia by taking effective preventive measures immediately and providing good nursing care.