后路经椎板间隙全内镜术治疗腰椎间盘突出症的护理探讨

Exploration on the nursing for patients suffering lumbar disc herniation and receiving posterior spinal approach endoscopic surgery

目的探讨后路经椎板间隙全内镜术治疗腰椎间盘突出症的护理模式与方法。方法总结本科后路经椎板间隙全内镜术治疗腰椎间盘突出症患者56例,对患者实施有效的病情观察及护理操作,全面的心理护理及功能锻炼指导等围手术期护理,其效果评价采用JOA,VAS评分。结果 42例患者术后第1天下地行走,14例术后第2天下床行走,术后2-4 d出院,住院期间无护理并发症发生。本组患者术前JOA评分9.8±2.3,VAS评分7.6±2.2分;术后JOA评分26.6±1.2,VAS评分2.6±0.7;术前术后评分差异有统计学意义（P〈0.05）,术后JOA改善指数为16.6±1.2;术后JOA评分改善率68%。结论术前充分的心理护理减少了患者对脊柱内镜手术的顾虑,术后积极的下床活动指导消除了患者对手术效果的担忧。有效的围手术期护理是腰椎间盘突出症患者接受内镜技术治疗后顺利恢复的重要措施。

Objective Aimed to explore the nursing mode and method in the treatment of Lumbar Disc Herniation（ LDH） by using posterior spinal approach endoscopic surgery. Methods Summarized datas of 56 cases of patients with lumbar intervertebral disc protrusion and received posterior spinal approach endoscopic surgery in our department. Carry out effective observation on patient＇s condition and nursing operation,including perioperative nursing like comprehensive psychological care and functional exercises guidance. The JOA,VAS scores were adopted to evaluate the effectiveness. Results 42 patients walked on the first day postoperative,14 cases walked on the next day after operation. They were discharged 2 to 4 days after operation. No nursing complications were observed during hospitalization. The preoperative JOA VAS score of this group of patients were9.8±2.3 and 7.6±2. 2 points. Postoperative JOA score was 26. 6 ± 1. 2,VAS score was 2. 6 ± 0. 7. Compared with those before operation,JOA scores and VAS scores significantly improved after surgery（ P〈0.05）. JOA improved index was 16.6±1.2; Postoperative JOA score improvement rate was 68%. Conclusions Sufficient preoperative psychological nursing reduced the patient＇s worry about the spinal endoscopic surgery,and positive postoperative walked guidance eliminates the anxious of the surgery effectiveness. So effective perioperative nursing is an important measure of uneventful recovery for lumbar disc herniation patients treated with endoscopic technology.