Dynesys动态稳定系统治疗腰椎退变性疾病围术期护理

Perioperative Nursing for Dynesys Dynamic Stable System in Treatment of Lumbar Degenerative Disease

目的探讨应用Dynesys动态稳定系统治疗腰椎退变性疾病的围术期护理措施。方法北京军区总医院脊柱外科2008年7月—2013年9月采用Dynesys动态稳定系统治疗腰椎管狭窄症和腰椎间盘突出症134例,围术期施行针对性的专科护理：术前加强心理护理,术后重点为观察肢体感觉和运动功能,及早行功能锻炼。术前、术后采用疼痛视觉模拟评分法（visual analogue scale,VAS）进行评分,入院及出院时调查患者对护理工作的满意度。结果本组术后2-3d拔除切口引流管后可佩戴支具下地活动,6周内生活均可完全自理;围术期无死亡病例,术后无原发症状加重及神经功能恶化。术后腰痛、下肢痛VAS评分显著低于术前（P〈0.01）;出院时患者对护理工作的满意度显著高于入院时（P〈0.01）。结论对应用Dynesys动态稳定系统治疗的腰椎退变性疾病患者施行针对性的围术期护理,能最大限度地保证手术效果,降低术后并发症的发生率,提高患者的满意度。

Objective To investigate the measure of perioperative nursing for Dynesys dynamic stable system in treatment of lumbar degenerative disease. Methods A total of 134 patients with lumbar spinal stenosis and lubar intervertebral disc protrusion during July 2008 and September 2013 were treated with Dynesys dynamic stale system. The special nursing was given during the operation; preoperative mental nursing was enhanced; postoperative nursing was focused on observing body sensation,motor function recovery and performing functional exercise as early as possible. Scores of lumbar and leg pain were detected by visual analogue scale（ VAS） before and after the operation,and the satisfaction degree of patients on nursing was also investigated upon admission and discharge. Results After removing drainage tubes2-3 d after the operation,early ambulation with orthosis was achieved,and full self-care was achieved within 6 weeks.There were no cases of death and nerve function aggravation after the operation. Postoperative VAS score was significantly lower than that before the operation（ P〈0. 01）; satisfaction degree on nursing was significantly improved upon discharge compared with that upon admission（ P〈0. 01）. Conclusion Dynesys dynamic stable system in treatment of patients with lumbar degenerative disease with special nursing in perioperative period can maximatily ensure the operation effect,reduce the incidence rate of postoperative complications and improve patients＇ satisfaction degree.