综合护理干预在腰椎爆裂骨折并发脊髓损伤患者中的应用效果

Effects of comprehensive nursing intervention on patients with lumbar burst fracture complicated with spinal cord injury

目的探讨综合护理干预在腰椎爆裂骨折并发脊髓损伤患者中的应用效果。方法选择2017年1月~2018年10月本院收治的腰椎爆裂骨折并发脊髓损伤患者行后路减压内固定术者90例。按照随机数字表法分为两组,各45例。观察组实施综合护理干预,对照组实施常规护理。比较两组干预后1个月的运动及感觉评分(ASIA评分),随访3个月,比较术后尿流动力学指标,随访1年,比较男性国际勃起功能指数(IIEF-5)及相关运动能力指标。结果干预后1个月,观察组运动功能及感觉功能ASIA评分大于对照组(P<0.05),干预后3个月,观察组最大尿流量及最大逼尿肌压力大于对照组(P<0.05),膀胱顺应性大于对照组(P<0.05),随访1年后,观察组IIEF-5评分高于干预前及干预后对照组(P<0.05),干预后1年,观察组完成步行10m耗时短于对照组(P<0.05),完成连续5次坐立位耗时短于对照组(P<0.05)。结论综合护理干预应用于腰椎爆裂骨折并发脊髓损伤患者中,能有效的恢复患者下肢感觉及运动功能,改善排尿及性功能,提高手术效果。

Objective To investigate the effect of comprehensive nursing intervention on patients with lumbar burst fractures and spinal cord injuries.Methods A total of 90 patients who underwent posterior decompression and internal fixation and treated in our hospital from January 2017 to October 2018 were selected.And they were divided into two groups using the random number method.with 45 cases in each group.The observation group was given comprehensive nursing intervention.and the control group was given routine nursing.The American spinal injury association scores(ASIA score)at 1 month after intervention was compared between the two groups;The postoperative urodynamic indexes was compared at 3-month follow-up;The male international index of erectile function(IIEF-5)and related sportscapacity indicators were compared at 1 year follow-up.Results At 1 month after intervention,the ASIA scores of the observation group were greater than those of the control group(P<0.05).At 3 months after intervention,the maximum urine flow,maximum detrusor pressure and bladder compliance in the observation group were greater than those in the control group(P<0.05).After 1 year of follow-up,the IIEF-5 score of the observation group was higher than that of the control group before and after the intervention(P<0.05).At 1 year after intervention,the time consuming on 10-meter walk and 5 consecutive sitting positions in the observation group was shorter than those in the control group(P<0.05).Conclusion The implementation of comprehensive nursing intervention for patients with spinal cord injury caused by lumbar burst fracture can effectively restore the sensory and motor functions of the lower limbs,improve urination and sexual function,and improve the surgical effect.