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胸腰椎爆裂骨折致神经损伤的危险因素及护理对策 被引量:12

Risk factors and nursing countermeasures of nerve damage caused by thoracolumbar burst fractures
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摘要 目的:探讨胸腰椎爆裂骨折致神经损伤危险因素,提出针对性的护理干预措施,为改善胸腰椎爆裂骨折患者的预后提供参考依据。方法选取山西省运城市中心医院骨科收治的375例胸腰椎爆裂骨折患者,采用自行设计的胸腰椎爆裂骨折致神经损伤危险因素相关问卷收集患者临床资料,对所得数据采用SPSS 19.0统计软件包进行描述性统计方法和Logistic回归分析法进行分析。结果患者胸腰椎爆裂骨折致神经损伤原因多见于交通事故,占43.64%;高处坠落占29.09%。 Logistic回归分析发现,老年(OR=1.63,P〈0.01)、损伤节段T12/L1(OR=20.95,P〈0.01)、后方韧带复合体损伤(OR=6.72,P〈0.01)、椎管内占位(OR=6.58,P〈0.01)是胸腰椎爆裂骨折患者致神经损伤危险因素。患者有骨折自救知识掌握程度(OR=0.52,P〈0.01)及其骨折自救措施(OR=0.21,P〈0.01)是胸腰椎爆裂骨折患者致神经损伤的保护因素。结论胸腰椎爆裂骨折患者易致神经损伤,其发生受很多因素影响,在临床工作中,除了做好胸腰椎爆裂骨折患者围术期护理工作外,对大众骨折自救知识健康宣教意义重大,可以通过互联网平台进行宣教,以减少神经损伤发生,改善患者的预后。 Objective To explore the risk factors of nerve damage caused by thoracolumbar burst fractures and put forward targeted nursing interventions so as to provide references for improving the prognosis of patients with thoracolumbar burst fractures. Methods We recruited 375 patients with thoracolumbar burst fractures of Department of Orthopedics in Yuncheng Central Hospital. The clinical data were collected with a self-made questionnaire related to risk factors of nerve damage caused by thoracolumbar burst fractures. The data were analyzed with the methods of descriptive statistics and logistic regression analysis using SPSS 19.0 statistical software.Results The major reasons of nerve damage caused by thoracolumbar burst fractures included traffic accidents (43.64%), falls from great heights (29.09 %). Logistic regression analysis showed that the risk factors of nerve damage caused by thoracolumbar burst fractures involved old age ( OR=1. 63, P〈0. 01 ) , damaged segments of T12/L1(OR=20.95, P〈0.01), rear ligament complex damage (OR=6.72, P〈0.01), intraspinal space-occupying (OR=6.58, P〈0.01). Besides, the protective factors of nerve damage caused by thoracolumbar burst fractures included the level of knowledge mastery on self-rescue of fractures ( OR=0.52, P〈0.01) and self-rescue measures of fractures (OR=0.21, P〈0.01).Conclusions The thoracolumbar burst fracture easily caused nerve damage with many influencing factors. In addition to carrying out well perioperative nursing service for patients with thoracolumbar burst fractures in clinic, it is important to provide health education on knowledge related to self-rescue of fractures for the public through an internet platform so as to reduce the occurrence of nerve damage and improve the prognosis of patients.
作者 韩红云 贾本让 程俊文 Han Hongyun Jia Benrang Cheng Junwen(Department of Orthopedics, Yuncheng Central Hospital, Yuncheng 044000, Chin)
出处 《中华现代护理杂志》 2016年第25期3571-3575,共5页 Chinese Journal of Modern Nursing
基金 卫生部医药卫生科技发展研究中心项目(W2014ZT044)
关键词 骨科 胸腰椎爆裂骨折 神经损伤 危险因素 横断面调查 护理对策 Department of Orthopedics Thoracolumbar burst fractures Nerve damage Risk factors Cross sectional survey Nursing countermeasures
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