胸腰椎后路手术两种俯卧位安置护理技术探讨.docVIP

精品论文 参考文献 胸腰椎后路手术两种俯卧位安置护理技术探讨 李聘兰 （重庆市南川区人民医院 408499） 　　【摘要】目的 探讨胸腰椎后路俯卧位手术体位安置改良方法的适用性。方法　将200例胸腰椎骨折内固定术、髓核摘除术、椎体滑脱行内固定术及内固定物取出术的病人随机分成对照组和观察组，对照组采用传统的手术体位安置方法，观察组采用改良的手术体位安置方法，观察手术患者术后反馈头面部、双上肢的舒适度及强迫体位所致安全性。结果　手术术中患者的舒适性、满意度、安全性及手术医生的满意度明显优于对照组。结论　体位经过改良后，效果更好，患者在术中更加安全与舒适，有利于手术医生操作，保证手术的成功及减少病人术后并发症，提高患者的舒适感及满意度，提高手术医生的满意度。 　　【关键词】 胸腰椎 后路手术 俯卧位 安置护理技术 　　【中图分类号】R473.6 【文献标识码】A 【文章编号】1672-5085（2013）37-0036-02 　　【Abstract】OBJECTIVE To investigate the thoracolumbar posterior surgical position placed in the prone position improved methods of applicability; Methods 200 patients who underwent thoracolumbar fracture internal fixation, resection of nucleus pulposus, spondylolisthesis underwent internal fixation and removal of internal fixation were randomly divided into the observation group and the control group. The patients in control group were treated by the traditional method of operation position, and the patients in observation group were treated by the improved method of prone position. The comfort of head and face and upper limbs and security in operation were told by patients and recorded. Results The observation group showed the better comfort, satisfaction and security than the control group. Conclusion After surgery position improved, the patients in the operation were more safe and felt more comfortable, and the improved position could help to operate, and contribute to the success of operation and the decrease of postoperative complications, and improve the patients comfort and satisfaction ,and the surgeon `s satisfaction. 　　【Keywords】 thoracolumbar spine posterior approach prone position care placed techniques 　　随着脊柱手术技术的成熟，该手术越来越多。脊柱后路手术均采用俯卧位，体位安置的要求：患者安全、舒适、无并发症；充分暴露手术视野，便于医生操作；固定牢固，不易移动，不影响呼吸、循环功能[1]。但该体位易造成患者生物学的改变，易导致呼吸循环衰竭，神经损伤和皮肤压疮等并发症[2]。为了保证手术的成功及减少病人术后并发症，提高病人的舒适感及满意度，方便手术医生操作，因此术中体位的安置非常重要。自2012年起我院部分脊柱后路手术采用改良俯卧位安置方法，采用改良俯卧位的患者，因体位安置不当而导致的并发症较传统俯卧位安置方法大大减少，并且效果更好，患者在术中更