胸腰段脊柱骨折合并骨盆骨折围手术期护理

[目的]观察胸腰段脊柱骨折合并骨盆骨折病人术前、术后护理效果。[方法]在30例胸腰段脊柱骨折合并骨盆骨折病人护理过程中，加强了术前术后护理、预防并发症护理及营养护理和功能锻炼。[结果]30例病人术后病变椎体高度恢复，尤其是矢状位生理曲度恢复良好，术后无肺不张、肺炎、压疮、泌尿系感染等并发症。[结论]加强对胸腰段脊柱骨折合并骨盆骨折病人的护理，可降低并发症的发生率。     

40例胸腰段脊柱结核病人围术期营养支持的护理

[目的]总结胸腰段脊柱结核病人围术期营养支持的护理.[方法] 对40例胸腰段脊柱结核病人进行病灶清除、椎体减压及植骨融合内固定术,术前、术后通过静脉途径增加营养供给,同时加强饮食宣教指导.[结果] 40例病人体重无减轻,伤口引流总量少,切口均甲级愈合.[结论]有效的营养支持有利于减轻手术和结核杆菌造成的机体营养不良,加强胸腰段脊柱结核病人围术期营养支持的护理有利于增强病人体质的抵抗力和术后恢复.     

前路手术治疗胸腰段不稳定性骨折的围手术期护理

[目的]探讨经前路手术治疗胸腰段不稳定性骨折病人的围手术期护理方法。[方法]回顾106例胸腰段不稳定性骨折采用前路减压、植骨、Zplate内固定治疗的病人进行围手术期心理护理、术前准备、术后体位护理、引流管护理、脊髓神经功能观察、康复训练等方面。[结果]106例病人没有出现神经功能损害加重,合并不完全截瘫病人有不同程度的神经功能改善,治疗护理效果满意。[结论]采用前路减压、植骨、Zplate内固定治疗胸腰段不稳定骨折,疗效确切,神经功能改善率高,有效重建脊柱的稳定性,围手术期进行有效的护理措施和康复锻炼,有助于病人平稳度过围手术期。     

前路手术治疗胸腰段不稳定性骨折的围手术期护理

[目的]探讨经前路手术治疗胸腰段不稳定性骨折病人的围手术期护理方法。[方法]回顾106例胸腰段不稳定性骨折采用前路减压、植骨、Zplate内固定治疗的病人进行围手术期心理护理、术前准备、术后体位护理、引流管护理、脊髓神经功能观察、康复训练等方面。[结果]106例病人没有出现神经功能损害加重，合并不完全截瘫病人有不同程度的神经功能改善，治疗护理效果满意。[结论]采用前路减压、植骨、Zplate内固定治疗胸腰段不稳定骨折，疗效确切，神经功能改善率高，有效重建脊柱的稳定性，围手术期进行有效的护理措施和康复锻炼，有助于病人平稳度过围手术期。     

40例胸腰椎爆裂骨折病人的围术期护理

[目的]总结胸腰椎爆裂骨折病人的围术期护理。[方法]对40例胸腰椎爆裂骨折病人行人工骨椎体内植骨联合后外侧植骨融合加钉棒系统内固定治疗,同时加强术前评估、心理护理、训练指导、常规准备、术后生命体征监测、体位护理、饮食护理、引流管护理、脊髓神经功能的观察、并发症的观察与护理等。[结果]40例病人均顺利手术,无护理并发症发生,达到满意的治疗效果,均顺利出院。[结论]加强胸腰椎爆裂骨折病人的围术期护理,是手术成功的保证。     

膨胀式椎弓根螺钉治疗老年骨质疏松性胸腰段脊柱爆裂性骨折的护理

目的探讨对膨胀式椎弓根螺钉治疗老年骨质疏松性胸腰段脊柱爆裂性骨折的护理方法。方法选择我院采用后路膨胀型椎弓根螺钉结合伤椎普通螺钉治疗老年骨质疏松性胸腰段脊柱爆裂骨折患者27例,在术前、术后进行严密地病情监测,予心理、生活护理、并发症的防护以及术后康复训练指导,观察其效果。结果 27例膨胀式椎弓根螺钉治疗的老年骨质疏松性胸腰段脊柱爆裂骨折患者,未出现护理相关并发症;经过18~31个月(24±2.7)月的随访,27例患者椎体高度明显恢复,脊柱后凸Cobb角矫正,未出现神经功能障碍。结论在术前、术后对患者病情的监测,予心理、生活护理及并发症的防护,术后正确及时的康复训练指导,是老年人骨质疏松性胸腰段脊柱爆裂骨折病情康复的必要保证。     

51例肺癌手术病人的安全护理

[目的]总结肺癌手术病人的安全护理。[方法]对51例肺癌病人在全身麻醉下行剖胸肺叶部分切除术,治疗过程中实施安全护理,加强术前准备、术后护理。[结果]51例病人术后均恢复良好,未出现护理不良事件,未发生术后并发症。[结论]加强肺癌手术病人的安全护理是手术成功的保证。     

胸腰段脊柱骨折前路减压植骨Z-plate内固定术的围手术期护理

目的:探讨胸腰段脊柱前路减压植骨Z-plate内固定术的围手术期的护理.方法:回顾性分析34例胸腰段爆裂骨折伴脊髓损伤患者的围手术期的护理,采用国际脊髓神经功能评定法评价患者术前、术后6周及6月时神经功能恢复情况.结果:经3个月至3年多的随访,28例患者脊髓功能有明显的恢复.结论:加强围手术期护理,注重心理护理、术后监测及康复指导是保证手术成功的关键.     

57例跟骨骨折病人术后并发症的护理

[目的]总结跟骨骨折病人术后并发症的护理。[方法]对57例跟骨骨折病人采用切开复位钢板内固定方法治疗,同时加强术后并发症护理。[结果]随访6个月～18个月,病人术后关节面恢复完整、功能恢复良好,按Maryland足部评分系统进行功能评定,优45例,良7例,可5例。[结论]加强跟骨骨折病人术后并发症的护理,是手术成功的保证。     

手术切除结合骨水泥填充固定治疗脊柱骨转移癌的护理

[目的]总结手术切除结合骨水泥填充固定治疗脊柱骨转移癌的护理方法。[方法]对26例脊柱骨转移癌病人采用切除肿瘤、脊髓减压结合骨水泥充填椎体强化治疗,其中15例加以椎弓根钉棒系统内固定。加强围术期护理,包括心理护理、体位训练及护理、生命体征监测、病情观察护理、并发症观察等,适时进行康复锻炼,做好出院指导。[结果]全部病人术后疼痛均获完全或部分缓解,18例有神经症状病人术后均有改善,2例不能恢复行走功能,无内固定失败,并发气胸1例,无护理并发症发生。[结论]手术切除结合骨水泥充填固定治疗脊柱骨转移癌,加强围术期护理,可有效减轻病痛,提高病人生活质量。     

Pelvic fracture

Pelvic fractures are common and often devastating injuries. Along with a high mortality, the long-term morbidity is consequential for both the individual patient and society. A thorough knowledge of the clinical approach will assist the emergency physician in providing optimal care and offer a rapid and effective treatment plan for life threatening hemorrhage. Using a case-based scenario, the initial management strategies along with rationale evidence-based treatments are reviewed.     

Colles' fracture

Many people "slip and fall", especially in the icy areas of the winter season. To prevent an injury to the head, most people put their hand out to hit the ground first, so the wrist usually gets injured. The most frequent injury from this type of "intervention" is a fracture to the distal radius and/or ulna, which is frequently called a "Colles' fracture."     

Boxer's fracture

Boxer's fracture is a common name for a fracture of the distal fifth metacarpal and received its name from one of its most common causes, punching an object with a closed fist. It can occur from a fistfight or from punching a hard object.The injury of a "Boxer's Fracture" earned the name from the way in which the injury occurred, punching an immovable object with a closed fist and no boxing mitt (Figure 1). Naturally, a "Boxer" usually punches his fist into his opponent's face or body. An angry person may perform the same action into a person, or into the wall. The third person may be performing a task and strike something with his fist with forceful action accidentally. In any event, if the closed fist "punches" into an immovable or firm object with force, the most frequent injury sustained would be a fracture of the fifth metacarpal neck. Some caregivers would also call a fourth metacarpal neck fracture a boxer's fracture.     

Anterior tibial spine fracture - an easy fracture to miss

Fractures of the intercondylar tibial spine are uncommon injuries that occur more frequently in the growing skeleton. They are easy to miss in the triage setting often being diagnosed as 'sprains' after sporting injuries. We report three cases that occurred in adolescents attending the same sporting event. We seek to highlight the importance of recognising these injuries so that the appropriate immediate treatment can be given.