胸腰椎骨折的围术期护理

目的探讨经伤椎一侧椎弓根螺钉固定，对侧经椎弓根通道椎体内植骨治疗胸腰椎骨折的围术期护理。方法2004年2月至2006年5月对26例胸腰椎骨折患者应用椎弓根钉棒系统后路伤椎一侧椎弓根螺钉固定，对侧经椎弓根通道采用自体髂骨或人工骨行椎体内植骨患者进行术前评估，并做好心理护理和术前准备及病情观察。术后严密观察病情变化及神经功能恢复情况，做好一般护理和康复功能锻炼及出院指导。结果全部26例获得随访，平均随访18．3个月，所有患者椎弓根钉棒系统无松动，无断钉断棒现象。全部伤椎高度及外形基本恢复正常，经伤椎椎弓根通道椎体内植骨愈合良好。神经功能恢复情况根Frankel评定标准：A级1例，B级1例，C级3例，D级5例，E级16例。结论对此类手术患者要重视术前心理护理和病情观察，术后加强病情观察、基础护理、康复功能锻炼及出院指导。

The perioperative nursing to patients who were treated of thoracolumbar vertebra fracture with unilateral bone graft in the fracture vertebral body through pedicle passage and opposite side pedicle screw fixation

Objective To study the perioperative nursing to patients who were treated of unilateral bone graft in the fracture vertebral body through pedicle passage and opposite side pedicle screw fixation thoracolumbar vertebra fracture. Methods There were 26 thoracolumbar vertebra fracture patients treated by unilateral pedicle screw fixation and opposite side bone graft through pedicle passage using iliac bone or artificial bone from February 2004 to January 2006. The patients condition were appraised and take psychological nursing and prepared before operation, After operation to strict observation condition change and nerve function restoration, take general Musing,do recoverey function exercise and give discharged instructions. Results All the patients had been followed up for average 18.3 months and there was no loosening and no breakdown of instrumentation. The height and shape of fracture vertebral body was fine. According to Frankel criterion, I case was in grade A, I in grade B,3 in grade C. 5 in grade D. and 16 grade. Conclusion To this kind of surgery patients must emphasize psychological nursing and the condition observation before operation, strengthen the condition observation, the based nursing, the recovery function exercise and discharged instructions after operation.