改良腰椎后路术后体位安置的临床研究

Clinical study on position placement after the modified posterior lumbar surgery

目的：探讨改良腰椎后路术后体位安置对患者舒适度和疗效的影响,以期提高临床诊治水平。方法选取2010年5月至2013年5月50例腰椎后路手术患者为研究对象,分成两组,对照组25例,术后给予一般护理,观察组25例,予以改良腰椎体位安置护理,观察护理后疗效变化。结果两组治疗后在躯体化评分、疼痛视觉模拟评分、生活质量评分、并发症发生率比较差异有统计学意义（ P〈0.05）；在舒适度上,对照组2 h、4 h、6 h的0~3分舒适度发生率分别为16%、28%、32%,7~10分舒适度发生率分别为48%、40%、28%；观察组2 h、4 h、6 h的0~3分舒适度发生率分别为32%、44%、60%,7~10分舒适度发生率分别为20%、20%、8%,两组比较差异有统计学意义（ P〈0.05）；两组在术后6 h、12 h、24 h、48 h切口引流量、血肿形成比较差异有统计学意义（ P〈0.05）。结论改良腰椎后路术后体位安置能提高患者舒适度,提高临床诊治有效率。

Objective To investigate the effect of position placement after the modified posterior lumbar sur-gery on the comfort degree and curative effects of patients, in order to improve the abilities of clinical diagnosis and treatment. Methods A total of 50 cases of modified posterior lumbar surgery patients from May 2010 to May 2013 were selected and divided into a control group and an observation group, with 25 cases in each group. The patients of the control group were given general care after surgery, while the patients of the observation group were given position place-ment care. The changes of curative effect after nursing were observed. Results After the treatment, the score of soma-tization, the score of visual analogue pain, the score of life quality and the occurrence rate of the complications between the two groups were all compared and the differences were statistically significant （ P〈0. 05 ）;in terms of the comfort de-gree, the occurrence rate of comfort grading from 0 to 3 points in 2 h, 4 h and 6 h were 16%, 28% and 32% respec-tively and the occurrence rate of comfort grading from 7 to 10 points in 2 h, 4 h and 6 h were 48%, 40% and 28% re-spectively. While the occurrence rate of the comfort grading from 0 to 3 points in 2 h, 4 h and 6 h of the observation group were 32%, 44% and 60%, and the occurrence rate of the comfort grading from 7 to 10 points in 2 h, 4 h and 6h were 20%, 20% and 8%, and the differences were statistically significant （ P〈0. 05 ）; while the volume of drainage and the formation of hematoma 6 h, 12 h, 24 h and 48 h after the operation of the two groups were compared and the differences were statistically significant （ P〈0. 05 ） . Conclusions Position placement after the modified posterior lum-bar surgery can improve the comfort index of patients, and enhance the efficiency of clinical diagnosis and treatment.