组合可调式头颅-骨盆牵引治疗重度僵硬型脊柱畸形的护理干预

Nursing intervention of combined adjustable Halo-pelvic traction for severe rigid spinal deformity

目的探讨组合可调式头颅-骨盆牵引治疗重度僵硬型脊柱畸形的护理要点。方法对我科2015年2月至2018年10月收治的接受颅盆环牵引的26例重度僵硬型脊柱畸形病人进行包括心理疏导、疼痛管理、心肺功能训练、牵引管理、神经症状观察、体位管理、针道护理和营养支持的护理干预。观察病人牵引前后的主弯Cobb角和并发症情况,采用Oswestry功能障碍指数(Oswestry disability index,ODI)评价病人的生活质量改善情况。结果 26例病人均安全、有效地完成颅盆环牵引,牵引后侧凸和后凸的Cobb角矫正率分别为43.8%和25.1%。3例出现暂时性牵引并发症,经护理干预后缓解。本组病人牵引后的ODI为(22.7±4.5)分,较牵引前的(40.0±2.2)分明显改善,差异有统计学意义(P<0.001)。结论系统的护理干预策略可有效减少颅盆环牵引并发症、改善病人舒适度,保证牵引安全、有效地完成。

Objective To investigate the nursing interventions of combined adjustable Halo-pelvic traction for severe rigid spinal deformity.Methods From February 2015 to October 2018,26 patients with severe rigid spinal deformity who received by Halo-pelvic traction treatment were given nursing interventions,including psychological guidance,pain management,cardiopulmonary function training,traction management,observation of neurological symptoms,position management,acupuncture nursing and nutritional support.The Cobb angle,complications were observed before and after traction.The improvement of patients was evaluated by Oswestry disability index(ODI).Results All 26 patients safely and effectively finished Halopelvic traction treatment,and the correction rate of Cobb angle was 43.8% for scoliosis and 25.1% for kyphosis after traction.Three patients had temporary traction-complication,which relieved after nursing intervention.The ODI of the patients after traction was 22.7±4.5,which was significantly than that before traction(P<0.001).Conclusion Systematic nursing intervention can effectively avoid the traction-related complications and improve patients’ comfort,and ensure that Halo-pelvic traction is finished safely and effectively.