62例MAST Quadrant通道镜下腰椎髓核摘除手术患者的围手术期护理

Perioperative nursing of 62 patients undergoing lumbar discectomy surgery with MAST Quadrant system

目的:总结探讨MAST Quadrant通道镜下腰椎髓核摘除手术患者的围手术期护理经验。方法:纳入62例单节段腰椎间盘突出症患者,均行MAST Quadrant通道镜下腰椎髓核摘除手术,分析总结围手术期护理措施,对患者进行适应性锻炼,练习床上大小便、轴线翻身并做好术前心理安慰等术前准备,术后严密观察患者病情变化,预防并发症的发生;保持伤口敷料干净、覆盖创面,避免伤口感染;保持尿道口清洁干燥,预防尿路感染;积极督促病人进行术后康复锻炼。结果:所有患者均于术后5~20天出院,随访1~6个月,长期随访患者腰痛、下肢麻木,疼痛等症状均有明显缓解甚至消失,术后出院时NRS评分为(0.7±0.4)分,JOA评分为(21.51±2.4)分,护理满意度为95.60%,术后1个月、3个月、6个月JOA改善率分别为72.30%,83.60%,91.40%。疗效显著。结论:良好的围手术期护理质量是MAST Quadrant通道镜下腰椎髓核摘除手术治疗成功的关键。

Objective:To summarize the experience of perioperative nursing of patients undergoing lumbar discectomy surgery with MAST Quadrant system.Methods:62 patients with single-stage lumbar disc herniation were enrolled in the research.All of them underwent MAST Quadrant endoscopic lumbar nucleus pulposus surgery.Perioperative nursing measures were analyzed and the patients were subjected to adaptive exercises.Preoperative psychological comfort and other preoperative preparations were made.Patient's condition after surgery was closely observed to prevent complications;wound dressing was kept clean and wound was kept covered to prevent wound infections;urethra were kept clean and dry to prevent urinary tract infections;patients were taught to do postoperative rehabilitation exercises.Results:All patients were discharged from the hospital 5 to 20 days after operation.Follow-up was 1 to 6 months.Long-term follow-up patients had low back pain,numbness of lower extremities,pain and other symptoms were significantly relieved or even disappeared.The NRS score at the time of discharge was(0.7±0.4).The scores of JOA were(21.51±2.4),and the satisfaction rate of nursing was 95.60%.The JOA improvement rates at 1 month,3 months,and 6 months after operation were 72.30%,83.60%,and 91.40%,respectively.The nursing effect is significant.Conclusion:Good perioperative care quality is the key to the successful treatment of lumbar nucleus pulposus surgery under the MAST Quadrant endoscope.