围手术期护理干预对于减少术后因素所致脑脊液漏的临床研究

目的：观察围手术期护理干预对于减少术后因素所致脑脊液漏的临床效果。方法：2012年6月~2013年1月,共有87例患者接受后路腰椎椎间盘切除＋椎间cage植骨＋椎弓根钉棒内固定术（posterior lumbar interbody fusion,PLIF）,其于围手术期接受心理干预、体位干预、呼吸道及消化道的预防性干预等护理措施（记为干预组）;同时收集2012年1~5月行PLIF术的72例患者资料,其于围手术期均未接受护理干预措施（记为非干预组）。比较两组术后脑脊液漏发生例数及所占比例、术后因素所致脑脊液漏的例数及所占比例。结果：干预组共出现8例脑脊液漏,其中因术后因素所致2例,术后因素所占比例为25%,术后脑脊液漏例数占未发生术中脑脊液漏例数的比例为2.5%。非干预组发生7例脑脊液漏,其中因术后因素引起4例,术后因素所占比例为57.1%,术后脑脊液漏例数占未发生术中脑脊液漏例数的比例为5.8%。结论：围手术期采取护理干预措施能够显著减少术后因素所致脑脊液漏的发生,具有较好的临床应用价值。

Clinical Research of Reduction of Cerebrospinal Fluid Leakage Induced by Postoperative Factors Using Perioperative Nursing Care

Objective：To clarify clinical result of reduction of cerebrospinal fluid leakage induced by postoperative factor using perioperative nursing care. Methods： From June 2012 to January 2013, a total of 87 cases underwent posterior lumbar interbody fusion （PLIF）, and all of them received perioperative nursing care, such as psychological intervention, body position intervention, respiratory intervention and digestive intervention （intervention group）. While from January 2012 to May 2012, another group composed of 72 cases did not receive aforementioned nursing care （non-intervention group）. Cases of cerebrospinal fluid leakage and its corresponding ratio, cases of cerebrospinal fluid leakage induced by postoperative factors and its corresponding ratio were analyzed. Results： In the intervention group, there were eight cases suffering from cerebrospinal fluid leakage, of which two of them were caused by postoperative factors, and its ratio was 25%. The percentage of cases suffering from postoperative eerebrospinal fluid leakage from cases without this complication was 2.5%. Meanwhile, for the non-intervention group, there were seven cases suffering from cerebrospinal fluid leakage, of which four of them were caused by postoperative factors, and its ratio was 57.1%. The percentage of cases suffering from postoperative cerebrospinal fluid leakage from cases without this complication was 5.8%. Conclusion： Perioperative nursing care is able to decrease cerebrospinal fluid leakage caused by postoperative factors significantly, owning excellent clinical application.