经皮椎体成形术治疗椎体压缩性骨折的围手术期护理体会

目的探讨经皮椎体成形术患者的护理方法及体会。方法通过护理措施的实施,观察经皮椎体成形术患者术后的疼痛及下床的时间。结果止痛时间术后2～24h,短时间内(12h～3d)病人可以下床活动。结论经皮椎体成形术有效的护理方法能促使病人早下床,避免并发症的发生。     

经皮穿刺椎体成形术33例的临床应用及护理

目的 介绍经皮椎体成形术的临床应用及护理.方法 对33例34个椎体行经皮穿刺椎体成形术治疗椎体压缩性骨折及血管瘤.术前行X线、CT或MRI检查,术中在C型臂X线机定位下,经皮穿刺至病灶部位,将骨水泥注入病灶,术中术后配合观察护理.结果 33例全部达到止痛效果.患者术后1～2天下床活动,无一例并发症发生.结论 实施经皮椎体成形术配合观察、护理,治疗椎体压缩性骨折及血管瘤具有强化椎体、镇痛、恢复椎体功能作用.     

经皮椎体成形术治疗椎体压缩骨折护理

目的对经皮椎体成形术治疗椎体压缩骨折的护理经验进行总结,希望能够让护理的工作质量得到有效提高。方法对45例进行了经皮椎体成形术的椎体压缩骨折患者进行了术前、术中和术后的科学护理,对护理的体会进行了认真总结。结果全部患者都成功的施行了经皮椎体成形术,患者在手术后的疼痛症状得到了很好的改善。结论通过加强术前、术中和术后的科学护理,能够有效避免术后并发症的出现,患者的骨质疏松状况能够得到有效改善,让患者能够更好的康复。     

经皮球囊椎体成形术的手术配合

目的探讨经皮球囊椎体成形术的手术配合及护理对策。方法对45例经皮球囊椎体成形手术进行观察和护理。结果 45例患者手术全部成功,安全度过手术期,无护理并发症发生。结论做好经皮球囊椎体成形术的术中配合和护理,能减少术后并发症,提高治愈率,同时做好术前、术中、术后护理是手术成功的关键。     

经皮穿刺椎体成形术治疗胸腰椎压缩性骨折的护理

目的总结应用经皮穿刺椎体成形术治疗胸腰椎压缩性骨折患者的护理特点和方法。方法115例胸腰椎压缩性骨折的患者在c臂机透视下接受了经皮穿刺胸腰椎体成形术。术前评估掌握相关合并症，术后监测生命体征，卧硬板床24h，适当指导患者进行康复训练。结果本组手术患者疗效显著，未发生护理相关并发症。结论细心的术前准备，配合医生做好术中、术后护理，能充分发挥经皮穿刺椎体成形术的治疗作用。     

29例压缩性骨折经皮椎体成形术的护理体会

目的观察经皮椎体成形术(PVP)治疗腰椎椎体压缩性骨折的效果及护理。方法在局麻下行PVP,C臂机监视下向骨折椎体穿入穿刺针,注入骨水泥,待骨水泥凝固后,拔除导引导管,达到有效恢复压缩椎体的高度,重建椎体强度与稳定性。护士给予相应的术前术后护理,为治疗提供保障。结果 29例患者PVP后CT示未见椎体的渗漏,患者未诉不适的症状,患者术后住院4～7d(平均6d)。29例术后患者腰部疼痛明显减轻,出院后患者已经可以佩戴腰部支具下床行走。结论对PVP患者给予相应的护理,能保障治疗效果,提高患者的生活质量,减轻患者的痛苦。     

经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的术后护理观察

目的：探讨经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的术后护理效果.方法：选取2013年6月至2014年5月我院收治的采用经皮椎体成形术治疗的骨质疏松性椎体压缩性骨折患者60例,随机分成观察组和对照组,每组30例,对照组实施常规护理,观察组在常规护理基础上实施术后整体护理干预,观察两组的疼痛评分与护理满意度.结果：经护理干预,两组的疼痛评分均明显降低,且观察组的降低水平明显优于对照组,护理满意度明显高于对照组（96.7%vs73.3%）,P〈0.05,有统计学意义.结论：对采用经皮椎体成形术治疗的骨质疏松性椎体压缩性骨折患者进行术后整体护理干预,能够有效减轻患者疼痛,提高护理满意度,促进患者早日康复,效果显著,值得临床推广.     

经皮穿刺椎体成形术治疗椎体压缩性骨折的疗效评价

目的：分析经皮穿刺椎体成形术治疗椎体压缩性骨折的疗效。方法：选取我院椎体压缩性骨折患者40例,收治时间为2012年3月至2013年8月期间,随机分为观察组和对照组,对照组采用传统手术治疗,观察组采用经皮穿刺椎体成形术治疗。结果：观察组椎体压缩性骨折患者治疗后椎体压缩率、伤椎Cobb角、骨水泥注入量、手术时间、术后伤椎高度增加、手术费用显著优于对照组（P＜0.05）。结论：经皮穿刺椎体成形术治疗椎体压缩性骨折具有良好的临床效果。     

经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的疗效观察及安全性评估

目的：研究经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的疗效及安全性。方法将老年骨质疏松性椎体压缩性骨折患者纳入研究,随机分为给予经皮椎体后凸成形术的PKP组、经皮椎体成形术的PVP组,观察手术相关指标、近期疗效情况及远期疗效情况。结果 PKP组的手术时间（128.2±16.4）h、术后椎间隙高度（11.4±1.7）明显高于PVP组[（82.3±10.1）h、（8.8±1.2）];骨水泥注入量（4.4±0.8）mL、骨水泥渗漏（6.15%）、下床活动时间（2.1±0.3）d、的腰部疼痛评分（1.5±0.3）、术后3、6、9、12月时的ODI评分（24.3±2.4、19.4±2.1、14.1±1.9、9.3±1.1）均明显低于PVP组[（7.1±1.0）mL、（18.46%）、（3.6±0.4）、（2.7±0.5）、（29.1±3.9）、（25.5±2.9）、（19.8±24）、（13.1±1.7）]。（P〈0.05）。结论经皮椎体后凸成形术能够减少骨水泥渗漏、促进临床症状缓解、改善远期机体功能,具有积极的临床价值。     

经皮椎体成形术治疗椎体骨质疏松性压缩性骨折

目的：探讨椎体成形术治疗老年性骨质疏松性压缩性骨折的诊断,治疗的适应症及相关技术。方法：回顾性分析经皮穿刺椎体成形术治疗20例患者26节椎体骨质疏松性压缩性骨折的椎体的术后疗效。结果：24节椎体采用单侧椎弓根入路的椎体成形术,2节椎体采用双侧椎弓根入路的椎体成形术治疗均获成功。术后2h及1d疼痛即明显缓解,术中注射骨水泥平均为5．2ml,有2节椎旁静脉丛有细条样骨水泥外渗,1节椎体后软组织内小条状漏出（经小切口钳出）。结论：20例26节椎体经皮穿刺椎体成形术是治疗老年骨质疏松性压缩性骨折的有效方法。     

胸腰椎骨折经皮椎体成形术患者的健康指导

目的:讨论应用经皮椎体成形术治疗骨质疏松性胸腰椎骨折患者的健康指导的作用。方法:2001年9月至2002年8月在本院对16例患者应用椎体成形术治疗进行了健康指导。结果:健康指导使患者增加了对胸腰椎骨折及椎体成形术的了解和进行正确的功能锻炼。结论:有效的健康指导可防止并发症的发生,促进患者康复。     

经皮椎体成形术治疗老年胸腰椎压缩性骨折

目的 分析经皮椎体成形术对老年骨质疏松胸腰椎压缩性骨折的临床效果及并发症.方法 2008年3月～2011年6月胸腰段椎体压缩骨折患者78例92个椎体,局部麻醉行经皮椎弓根穿刺椎体内注射骨水泥强化压缩骨折椎体,对术前术后腰椎疼痛,手术椎体前缘高度等数据分析.结果 术后随访时间8～21个月,平均12个月,手术前后骨折椎体前缘高度丢失率低于5%;术后3d疼痛缓解明显,VAS评分为(1.8 ±1.2);较术前VAS评分(7.2 ±1.6)明显下降,主观治疗满意度为96%;术后自由下地站立时间为(5.6 ±2.7)d; 2例术后出现一侧下肢疼痛麻木,经对症治疗好转,不影响下肢功能;5例出现无症状椎管内骨水泥渗漏,7例出现椎体周围骨水泥渗漏,没有症状未予处理.结论 经皮椎弓根椎体成形术对老年胸腰椎压缩性骨折近期治疗效果良好,疼痛缓解及功能恢复满意,有效的强化骨折椎体的强度,明显改善患者的生活质量.     

Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: review of the literature

OBJECTIVE: To determine the effectiveness and safety of percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures as published in the scientific literature. DESIGN: Literature review. METHOD: Medline and the Cochrane library were searched with the terms 'percutaneous vertebroplasty', 'vertebral compression fractures', 'osteoporotic' and 'osteoporosis'. Criteria for inclusion were: (a) the studies had to have been published in the period January 1985-August 2002, (b) the study population had to include at least 10 patients, (c) the patients had to have been treated with percutaneous vertebroplasty, and (d) the diagnosis had to have been 'osteoporotic vertebral compression fracture'. RESULTS: Twelve studies met the inclusion criteria. Pain relief was seen in 60%-100% of the patients within the first 24 hours and this result improved to 78-100% in the long term (maximum 4 years). The complications immediately after the procedure were related to cement leakages and were mostly of no clinical consequence. Serious complications such as pulmonary embolism were rare. In the long term, percutaneous vertebroplasty was associated with an increased risk of fractures in the adjacent vertebrae. CONCLUSION: Percutaneous vertebroplasty seems to be effective and safe in the treatment of osteoporotic vertebral compression fractures. A prospective randomised intervention study has, however, not yet been performed. For the time being, percutaneous vertebroplasty should be reserved for carefully selected patients in whom conservative therapy has not produced results.     

经皮椎体成形术及后凸成形术治疗骨质疏松性多椎体压缩骨折

目的观察经皮椎体成形术及后凸成形术治疗骨质疏松性多椎体压缩性骨折的临床疗效。方法根据患者的临床表现、影像学特征,对27例患者进行经皮椎体成形术或球囊扩张椎体后凸成形术。观察术后3d和随访时的活动能力（MDS）、疼痛强度视觉模拟评分（VAS）较术前的改善情况。结果27例均成功完成手术,术后疼痛基本消失,72h后均离床活动,患者的视觉模拟评分（VAS）术后3d（2．2±0．9）,较术前（7．8±1．4）显著下降（P〈0．01）;随访时VAS为（1．5±1．0）,较术后又有所下降。MDS术后3d（1．0±0．8）,较术前（2．4±1．2）显著下降（P〈0．01）;随访时为（1．0±0．9）,与术后相当。术后随访5～12个月,腰痛无复发。结论对于骨质疏松性多椎体压缩骨折的患者,根据骨折椎体的特征,行经皮椎体成彤术结合后凸成形术,为患者降低一定的医疗费用,短期疗效满意,其长期疗效有待于进一步随访验证。     

CT导向下经皮椎体成形术治疗脊椎转移性肿瘤

目的探讨CT导向下椎体成形术治疗椎体转移瘤的疗效。方法对40例椎体转移瘤共50个椎体溶骨性病灶在CT导向下施行椎体成形术治疗,术后观测症状改善、骨水泥渗漏及并发症情况。结果40例患者手术穿刺全部成功,本组病例术后均有不同程度疼痛缓解或消失,无一例发生严重并发症。结论在CT定位引导下行经皮椎体成形术操作简便、安全、并发症少、镇痛效果好,对提高患者的生存质量有很好的应用价值。     

疼痛教育对胃大部切除术后疼痛护理质量的影响

目的探讨疼痛教育对胃大部切除术后疼痛护理质量的影响。方法84例拟施行胃大部切除术的患者随机分为疼痛教育组(干预组)与未给予疼痛教育组(对照组),每组各42例。干预组由责任护士在手术前一天给予疼痛教育,对照组未给予疼痛教育。术后24h评估镇痛需求和镇痛治疗满意度;评估术后48h内睡眠时间;评估术后恢复情况(首次下床活动时间、首次肛门排气时间)。结果干预组术后镇痛需求和疼痛治疗满意度明显高于对照组(p<0.01);术后48h内睡眠时间明显长于对照组(p<0.01);首次下床活动时间及首次肛门排气时间均早于对照组(p<0.05)。结论疼痛教育能显著提高胃大部切除术患者的术后镇痛需求与治疗满意度,改善了疼痛护理质量,同时促进了患者的早日康复。     

Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: first short term results

OBJECTIVE: To describe the technique of percutaneous vertebroplasty and the short-term results in patients with symptomatic, osteoporotic vertebral compression fractures. DESIGN: Prospective follow-up study. METHOD: In a pilot-study to evaluate the short-term safety and effectiveness of percutaneous vertebroplasty, 18 consecutive patients with a total of 33 osteoporotic thoracic or lumbar vertebral compression fractures were treated from October 2001 to June 2002 with a follow-up of 3-6 months. The indication for treatment was a symptomatic, therapy-resistant osteoporotic vertebral compression fracture. Percutaneous vertebroplasty was performed under radiographic control, after previous intraossal venography, using bone cement mixed with barium sulphate. Post-procedural follow-up consisted of radiological evaluation with conventional thoracolumbar X-rays and MRI scans, and interviews of the patients. RESULTS: Percutaneous vertebroplasty was technically successful in 31 of 33 vertebral fractures (94%), and in 16 of 18 patients (89%). One patient with extreme venous contrast leakage could not be treated. Sixteen patients had less or no pain after treatment. One patient retained thoracolumbar back pain after inadequate cementations and refused further treatment. None of the patients reported aggravation of symptoms following the procedure. Contrast leakage was absent in 18 vertebrae. In 8 vertebrae there was contrast leakage to paravertebral veins. In three of these cases the leakage was so severe that embolisation was performed, with success in one case. In 13 vertebrae, cement leakage to intervertebral and paravertebral spaces and pedicular cement spurs were seen, without clinical consequences. Immediately after the procedure and during follow-up there were no clinically relevant complications. CONCLUSION: Percutaneous vertebroplasty was a technically feasible treatment in these patients with symptomatic, therapy-resistant, osteoporotic vertebral fractures. The first short-term results were comparable with results in the literature. A prospective randomised intervention study will be needed to compare percutaneous vertebroplasty with optimal conservative treatment.     

经皮球囊扩张椎体成形术的临床疗效观察

目的探讨经皮球囊扩张椎体成形术治疗骨质疏松性椎体骨折与骨肿瘤的临床疗效。方法对30例椎体病变患者采用经皮球囊扩张椎体成形术(PVP)手术方式治疗,对治疗结果进行回顾性统计分析。结果术后椎体高度、Cobb角、疼痛VAS评分均较术前改善,有13例出现少量椎体旁骨水泥渗漏;30例术后随访2～24个月,平均8个月。随访期间,患者的胸腰椎病变处疼痛明显缓解。结论经皮球囊扩张椎体成形术治疗老年骨质疏松性椎体骨折及椎体肿瘤有确切的临床疗效。     

冠状动脉介入术后患者卧位及卧床时间的研究

目的探讨经皮冠状动脉内介入治疗(PCI)患者术后的卧位类型、及卧床时间对患者舒适度及并发症的影响。方法将2009年5月～2010年9月的140例PCI术后患者随机分为对照组(A组)60例,实验组(B组)80例。A组术后采用传统方法护理,穿刺点用弹性绷带包扎并且用1 kg沙袋压迫12 h,保持术侧肢体制动、平卧12 h,卧床24 h后下床活动。B组术后穿刺点用弹性绷带包扎并用1 kg沙袋压迫4 h,术侧肢体伸直,可水平移动,对无血管并发症者可根据患者需要取术侧卧位、仰卧位或半卧位(床头抬高30～45度)交替,4 h后床上自主体位,12 h后可床旁活动。结果2组患者术后并发症的发生率差异无统计学意义,B组的舒适程度显著优于A组。结论 B组的护理方法可提高患者的舒适度,减轻心理压力。