严重强直性脊柱炎性脊柱后凸矫形手术的术中护理

论证指向严重强直性脊柱炎性脊柱后凸矫形手术患者推进规范术中护理处置的价效。方法 2022年7月-2023年8月,将84例严重强直性脊柱炎性脊柱后凸矫形手术患者分两组,各42例,参照组常规术中护理,研究组规范术中护理,测算对比两组的护理服务质量满意度计量指示值。结果 研究组的护理服务质量满意度计量指示值优于参照组(P<0.05)。结论 围绕严重强直性脊柱炎性脊柱后凸矫形手术患者推进规范术中护理处置,质效显著,值得推广。

小儿颞颌关节强直手术的麻醉处理

目的 探讨小儿颞下颌关节强直手术的麻醉方法及并发症的防治。方法 3 1例病人全‘部经鼻腔盲探插管。结果 麻醉插管成功 3 0例 ,气管切开 1例 ,全麻诱导与插管期间发生低氧 6例 ,鼻出血 2例 ,导管插入后出现呛咳 5例。结论 充分的鼻腔准备和完善的咽喉表面麻醉是经鼻腔插管成功的关健。患者年龄越小麻醉的风险越大 ,并发症越多。

强直性脊柱炎的全髋关节置换术

为探讨强直性脊柱炎合并髋关节骨性强直患者同期行双侧全髋关节置换术的疗效。对12例强直性脊柱炙合并双侧髋关节骨性强直患者同期行双侧全髋关节置换术（24个髋关节），通过对手术前后关节疼痛、活动度及患者整体功能改善情况的观察，确定此方法的疗效。结果12例患者平均随访3．2年，髋关节功能均明显改善，髋关节屈曲畸形消失，髋关节活动范围达到前屈70～105°，平均84．4°，后伸5～15°，平均8．6°，无髋关节疼痛，膝痛及下背痛明显改善。表明全髋置换术是治疗强直性脊柱炎晚期严重髋关节病变的一种有效的方法。同期双侧全髋关节置换术具有缩短治疗周期、协调术后双侧髋关节功能的恢复、减少患者痛苦和节省治疗费用的优点。

护理干预在强直性脊柱炎后路手术体位护理中的应用分析

目的:分析体位护理干预应用于强直性脊柱炎后路手术中的临床应用价值。方法:选取我院行强直性脊柱炎后路手术的90例患者,根据患者医院分为对照组和观察组,对照组给予术中常规护理,观察组在对照组的基础上加入体位护理干预,对比两组患者术中并发症发生率,比较临床医师的满意率。结果:经过护理,观察组患者术后发生并发症的概率为2.2%,对照组为15.6%P<0.05;比较临床医师满意率,观察组总满意率为97.8%,对照组为77.8%,观察组临床医师满意率显著优于对照组P<0.05。结论:强直性脊柱炎后路手术患者术后出现并发症会严重影响患者的预后,加重患者的病情,应加强术后的体位护理,降低术后患者并发症的发生率,改善患者的预后,提高护理效果及临床医师满意率,具有临床推广的价值。

Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis

Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel＇s score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach. Results： There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a longterm complication in follow-up. Conclusions： The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.