3D打印人工颈椎植入术围手术期护理

Nursing care of lower cervical spine fracture treated with 3D print microporous titanium artificial vertebral body

目的总结3D打印人工颈椎植入术治疗下颈椎骨折的围手术期护理措施及效果。方法应用3D打印人工颈椎行植入内固定术治疗下颈椎骨折15例,术前颈椎妥善制动预防脊髓损伤加重、严密观察临床症状,协助医生行颈椎的CT三维重建,从而计算出伤椎的生理高度;术中保持体位固定、精心准备配套器械、熟悉手术相关步骤及配套器械的使用安装,准确传递各类手术器械,协助术中透视检查;术后重点监测呼吸及血氧饱和度的变化,观察颈部有无肿胀、有效保持呼吸道通畅,观察脊髓神经功能的变化,制订个性化的功能锻炼计划、促进康复并积极预防并发症。结果日本矫形外科学会(JOA)评分由术前的(9.23 ± 1.62)分提高到术后的(14.09 ± 1.35)分,改善率为62.55%。无吞咽困难、声音嘶哑、呼吸困难等并发症。结论通过3D打印人工颈椎植入术治疗下颈椎骨折的针对性围手术期护理,可减少手术并发症、改善患者生命质量。

Objective To summarize the perioperative nursing measures and effects of 3D printed artificial cervical vertebrae for lower cervical spine fractures. Methods Treatment of 15 cases of lower cervical spine fracture with 3D printed artificial cervical vertebrae. Preoperative cervical spine fixation to prevent spinal cord injury, strict observation of clinical symptoms, assist the doctor to perform CT three-dimensional reconstruction of the cervical spine, and calculate the physiological height of the injured vertebrae;maintain the surgical position fixed during surgery, carefully prepare the supporting equipment, familiar with the surgical related steps, accurate delivery of all types of surgical instruments to assist with intraoperative fluoroscopy. Postoperative focus on the neck to see if there is swelling, effectively maintain the airway patency, observe changes in spinal nerve function, develop a personalized functional exercise program to promote rehabilitation, and actively prevent complications. Results The JOA score increased from (9.23±1.62) points before surgery to (14.09±1.35) points after surgery, and the improvement rate was 62.55%. There were no complications such as difficulty swallowing, hoarseness, and difficulty breathing. Conclusions Through targeted perioperative care, surgical complications can be reduced and the quality of life of patients improved.