重度脊柱侧弯畸形患者围术期的护理干预

Perioperative Nursing Intervention for Patients with Severe Scoliosis

目的:探讨重度脊柱侧弯畸形截骨矫形、植骨融合内固定术患者围术期的护理要点。方法:回顾性分析2012年5月-2017年5月我科收治的重度脊柱侧弯畸形患者56例的临床资料,所有患者术前进行系统评估、健康宣教、呼吸功能训练、营养评估、床上大小便训练、唤醒试验,术后进行严密的病情观察、有效的阶梯镇痛管理、呼吸道管理、脊髓神经功能的观察、舒适的体位护理、引流管管理、胃肠道管理、生活照顾、早期功能锻炼。结果:56例患者中4例发生胸腔积液,留置胸腔闭式引流管;1例发生肠系膜上动脉综合征;2例发生精神障碍,经过积极治疗和精心细致的护理均恢复良好,效果满意。结论:系统的有计划的优质护理是保证手术顺利完成的关键,术后严密精准的护理可减少术后并发症的发生,促进患者早日康复,提高患者住院满意率。

Objective:To investigate the perioperative nursing of patients with severe scoliosis deformity who has undergone osteotomy,fusion and internal fixation surgery.Methods:This retrospective study has enrolled Fifty - six patients with severe scoliosis from May 2012 to May 2017.All patients were evaluated systematically,and had been treated by health education,respiratory function training,nutrition assessment,urine on the bed and awakening test preoperatively.After the surgery,the patients had been treat by strict observation of the condition,effective ladder analgesia management,respiratory tract management,spinal nerve function observation,comfortable position nursing,drainage tube management,gastrointestinal management,life care,early functional exercise.Results:Four out of 56 patients developed pleural effusion and retained thoracic drainage tube.One patient had superior mesenteric artery syndrome.Two patients had mental disorders.After active treatment and careful and meticulous care,they all recovered well with satisfactory results.Conclusion:Systematic and planned high 一 quality care is the key to ensure the successful completion of the surgery.Careful and accurate postoperative care can reduce the occurrence of postoperative complications,promote early recovery of patients,and improve patients'hospitalization satisfaction rate.