单节段颈前路椎间盘切除融合术后引流及护理

Application of drainage with and without negative pressure after single-level anterior cervical discectomy and fusion and related nursing measures

目的对比单节段颈前路椎间盘切除椎间植骨融合(ACDF)术后负压引流与常压引流的效果,总结护理措施。方法 26例行ACDF手术的患者分组为研究组和对照组,各13例。2组患者术后基础处理相同。对照组术后实施常规负压引流,研究组行常压引流。观察拔出引流管前并发症发生情况,记录2组引流量、换药次数、护理总次数等。结果 2组患者术后均未出现颈部血肿、气管压迫、神经或脊髓损害的并发症表现。术后引流量研究组(12. 20±7. 20) mL,小于对照组的(21. 10±8. 60) mL,差异有统计学意义(P <0. 01)。术后至拔管时换药次数研究组(2. 20±0. 40)次,对照组(2. 50±0. 50)次,2组差异无统计学意义(P> 0. 05)。护理次数对照组多于研究组(P <0. 05)。结论单节段ACDF术后常压引流可减少术后引流量,减少护理工作量,是一种可供临床思考和进一步研究的护理方法。

Objective To evaluate the drainage with and without negative pressure after sin- gle-level anterior cervical discectomy and fusion（ ACDF）, and to summarize related nursing meas- ures. Methods Totally 26 patients undergoing single-level ACDF were randomly divided into the study group and the control group, with 13 cases in each group. The drainage with negative pressure was performed in the control group, and the drainage without negative pressure was a- dopted in the study group. The postoperative complications, volume of postoperative drainage flu- id, frequency of dressing changes and overall times of nursing before withdrawing drainage tube were observed and compared between two groups. Results There was no complication such as cervical hematoma, tracheal oppression, nerve or spinal cord injury in both two groups. The vol- ume of postoperative drainage fluid of the study group （12.20± 7.20 mL）was less than that of the control group（21.10 ±8.60 mL） ,with a significant difference（P 〈0.01 ）. There was no sig- nificant difference in the frequency of dressing change between study group （2.20 ± 0.40 ） and control group （2.50 ±0.50 ） after operation （ P 〉 0.05 ）. Patients of the control group received more times of nursing management for drainage tube compared with those in the study group （P 〈 0.05）. Conclusion Application of drainage without negative pressure may reduce the volume of postoperative drainage fluid after ACDF, which in turn reduce the workload of nurses.