老年骨质疏松性椎体压缩骨折机器人辅助下经皮椎体后凸成形术的围手术期护理

Perioperative nursing of robot assisted percutaneous kyphoplasty for senile osteoporotic vertebral compression fractures

目的总结机器人辅助下老年骨质疏松性椎体压缩骨折患者行经皮椎体后凸成形术(PKP)围手术期护理要点,为骨科护理提供借鉴。方法回顾性分析2019年7月至2021年2月在安徽医科大学第一附属医院骨科脊柱外科行机器人辅助下PKP治疗的72例老年骨质疏松性椎体压缩骨折患者资料,归纳围手术期护理要点,总结护理经验,分析探讨精准微创治疗新举措下的护理。收集患者住院时间、术后下床时间、并发症发生情况及满意度调查结果,比较手术前后的疼痛数字评分法(NRS)评分、焦虑自评量表(SAS)评分和Oswestry功能障碍指数(ODI)评分,结合各因素评分结果的关联性分析综合评价手术和护理效果。结果所有患者术中及术后未发生机器人使用相关并发症,症状均得到不同程度的改善。57例留置尿管,置管时间(19.00±14.24)h;术前住院时间(6.16±2.22)d,术后住院时间(1.94±0.99)d;术后下床时间(16.34±6.81)h;术后护理满意度(98.55±2.44)%;术后NRS、SAS评分分别为(1.00±0.55)、(32.06±5.33)分,低于术前的(3.51±0.71)、(39.08±8.86)分,差异均有统计学意义(t值为33.976、8.184,P<0.01);手术前后ODI评分中的腰痛、行走、站立、坐立、睡眠和生活自理6个指标比较差异均有统计学意义(P<0.01)。关联性分析表明6个ODI评分因素与NRS评分之间的关联性均较强,各因素之间相互关联;而坐立、行走、腰疼和站立4个因素与SAS关联度较高。结论对机器人辅助下PKP的老年骨质疏松性椎体压缩骨折患者实施良好的围手术期护理管理能有效促进患者康复,降低并发症发生率,提高患者满意度。

Objective To summarize the perioperative nursing points of percutaneous kyphoplasty(PKP)in elderly patients with osteoporotic vertebral compression fractures assisted by robots,so as to provide reference for orthopedic nursing.Methods From July 2019 to February 2021,the data of 72 patients undergoing robot-assisted PKP in the spinal surgery of the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.The perioperative nursing points were summarized,and the nursing experience was summarized.The nursing under the new measures of precise minimally invasive treatment was analyzed and discussed.The length of hospital stay,postoperative ambulation time,complications and satisfaction survey results of patients were collected and recorded.The Numerical Rating Scale(NRS)score,Self-rating Anxiety Scale(SAS)score and Oswestry Disability Index(ODI)score before and after surgery were compared.The correlation analysis of the scores of various factors was combined to comprehensively evaluate the surgical and nursing effects.Results All patients had no complications related to machine use during and after operation,and their symptoms were improved to varying degrees.Fifty-seven cases of indwelling catheter,catheter time(19.00±14.24)h.The preoperative hospitalization time was(6.16±2.22)d,and the postoperative hospitalization time was(1.94±0.99)d.Postoperative bed time was(16.34±6.81)h.Postoperative nursing satisfaction was(98.55±2.44)%.The postoperative NRS and SAS scores were(1.00±0.55)and(32.06±5.33)points,respectively,which were lower than those before operation(3.51±0.71)and(39.08±8.86)points,and the differences were statistically significant(t values were 33.976,8.184,P<0.01).There were statistically significant differences in six indicators of ODI scores before and after surgery,including low back pain,walking,standing,sitting,sleep and self-care(P<0.01).Correlation analysis showed that there was a strong correlation between the six ODI score factors and the NRS score.The four factors of sitting,walking,low back pain and standing were highly correlated with SAS.Conclusions The implementation of good perioperative nursing management for patients with PKP assisted by robot can effectively promote the rehabilitation of patients,reduce the incidence of complications and improve patient satisfaction.