手术室系统化护理在脊柱骨折伴脊髓损伤手术患者中的应用效果

Application Effect of Systematic Nursing in Operating Room in Surgical Patients with Spinal Fracture and Spinal Cord Injury

目的:探讨手术室系统化护理在脊柱骨折伴脊髓损伤手术患者中的应用效果。方法:选取2020年4月—2022年4月三明市第二医院收治的264例脊柱骨折伴脊髓损伤手术患者。根据随机数表法将其分为对照组及观察组,各132例。对照组给予常规术中护理,观察组给予手术室系统化护理。比较两组术后当天、3 d、5 d的压力性损伤发生率、损伤面积、损伤程度,术后当天及术后5 d凝血指标,下肢静脉血栓发生率。结果:术后当天、3 d、5 d,观察组压力性损伤发生率低于对照组,压力性损伤患者损伤面积小于对照组,压力性损伤患者的损伤程度优于对照组,差异有统计学意义(P<0.05)。术后当天、5 d,观察组D-二聚体(D-D)、纤维蛋白原(FIB)水平均低于对照组,凝血酶原时间(PT)长于对照组,差异有统计学意义(P<0.05)。术后5 d内,观察组下肢静脉血栓发生率为3.79%(5/132),低于对照组的10.61%(14/132),差异有统计学意义(χ^(2)=4.594,P=0.032)。结论:手术室系统化护理应用于脊柱骨折伴脊髓损伤手术患者中有助于改善凝血功能,降低下肢静脉血栓和压力性损伤发生率,减小损伤面积,减轻损伤程度。

Objective:To explore the application effect of systematic nursing in operating room in surgical patients with spinal fracture and spinal cord injury.Method:A total of 264 surgical patients with spinal fracture and spinal cord injury were selected from April 2020 to April 2022 in Sanming Second Hospital.They were divided into control group and observation group according to random number table method,132 cases in each group.The control group received routine intraoperative nursing,and the observation group received systematic nursing in operating room.The incidence of stress injury,injury area and injury degree on the day,3 d and 5 d after surgery,blood coagulation index on the day and 5 d after surgery,and the incidence of lower limb venous thrombosis were compared between the two groups.Result:On the day,3 d and 5 d after surgery,the incidence of stress injury in the observation group were lower than those in the control group,the injury area in the patients with stress injury were smaller than those in the control group,and the injury degree in the patients with stress injury were better than those in the control group,the differences were statistically significant(P<0.05).On the day and 5 d after surgery,D-dimer(D-D)and fibrinogen(FIB)levels in observation group were lower than those in control group,and prothrombin time(PT)were longer than those in control group,the differences were statistically significant(P<0.05).Within 5 d after surgery,the incidence of venous thrombosis in lower extremity in the observation group was 3.79%(5/132),which was lower than 10.61%(14/132)in the control group,the difference was statistically significant(χ^(2)=4.594,P=0.032).Conclusion:The application of systematic nursing in operating room for the surgical patients with spinal fracture and spinal cord injury can help them to improve the blood coagulation function,reduce the incidence of lower limb venous thrombosis and stress injury,reduce the area of injury,and reduce the degree of injury.