硬膜外腔导管松解联合神经根孔外韧带剥离术患者的围手术期护理
Perioperative nursing of patients with spinal stenosis undergoing adhesiolysis combined selective percutaneous extraforaminotomy with foraminal ligament resection and caudal epidural injections
目的 探讨硬膜外腔导管松解联合神经根孔外韧带剥离治疗腰椎管狭窄症的护理方法.方法 对收治的36例行硬膜外腔导管松解联合神经根孔外韧带剥离术患者术前给予全面的心理疏导、体位训练,术后给予常规护理和专科护理,观察相关护理对患者康复的作用及效果,采用Oswestry功能障碍指数(ODI)评价临床疗效.结果 36例患者术后ODI获得明显改善,根据ODI改善率得出的手术临床效果:优13例(36.1%),良17例(47.2%),可3例(8.3%),差3例(8.3%),优良率为83.3%.未发生感染、硬膜外血肿、术中大出血等并发症.结论 经皮、经骶管行硬膜外腔导管松解,精确药物注射,选择性联合应用神经根孔外韧带剥离技术,可以有效缓解腰椎管狭窄症所致腰腿痛症状;术前、术后给予正确、恰当的护理能很好地改善椎管狭窄,避免并发症的发生,提高手术成功率.
更多Objective To investigate the postoperative care for patients with spinal stenosis who underwent adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection and caudal epidural injections.Methods Special care such as psychotherapy,posture training,routine nursing and so on were adopted for 36 cases during the operation of adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection and caudal epidural injections,and the effects and results of patients' rehabilitation were observed.Results Among 36 patients,they achieved satisfactory clinical results and postoperative Oswestry Disability Index (ODI) significantly were improved with 13 cases very good,17cases good,3 cases not bad,and 3 caes poor.No severe surgery complications such as infection,epidural hematoma,blood bleeding occurred.Conclusions Percutaneous epidural adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection may be effective in patients with chronic low back and lower extremity pain secondary to lumbar spinal stenosis.Complications of surgery could be prevented,recovery time could be shortened,and success rate could be enhanced by giving the accurate and proper care during the operation.
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