胸椎黄韧带骨化症围术期护理体会

目的总结胸椎黄韧带骨化症围术期护理经验。方法选择行全椎板切除、黄韧带骨化块切除脊髓减压的黄韧带骨化症患者31例，给予围术期康复护理，随访12—36个月。结果27例患者术后症状立即缓解；3例术后7～14d胸部束带感、双下肢胀痛等症状逐渐消失，2-6周双下肢麻木、沉重感消失，肌张力恢复正常，并恢复工作；神经症状无继续发展，双下肢麻木僵硬感无明显变化1例。3例发生脑脊液漏，经降颅压治疗、体位护理、局部加压及全身支持治疗后愈合，1例患者出现肺炎发热，经雾化排痰、翻身叩背护理后治愈。术后JOA下肢运动功能评分由术前的（1．22±0．96）分提高到（3．76±0．68）分，括约肌功能评分由术前的（1．97±0．52）分提高到（2．68±0．46）分。结论针对性术前心理指导，可使胸椎黄韧带骨化症患者尽快接受手术治疗，术前进行适应性训练，改善呼吸功能，术后严密观察双下肢的肌力、感觉变化，做好体位及康复训练，同时做好脑脊液漏、下肢深静脉血栓等的预防护理．可明屙提高手术成功率．促讲患者康每．

Perioperative nursing experience for the ossification of the thoracic liga- mentum flavum

Objective To observe and summary the nursing experience for the ossification of the thoracic ligamentum flavum. Methods 31 patients with the ossification of thoracic ligamentum flavum were given laminectomy and spinal cord decompression, then given the perioperative rehabilitation nursing, and were followed up for 12-36 months. Results The symptoms of 27 cases relieved quickly and these patients recovered to work.In 3 cases with cerebrospinal leak, the symptoms of chest zonesthesia and both lower extremities＇ pain disappeared gradually at 7-14 days after surgery, feel- ing of numbness and loading from both lower extremities disappeared at 2-6 weeks, patients＇ muscular tension recov- ered and then went to work. One case＇s neurologic symptoms were not continuously developed and numb stiff feeling had no significant changes. 3 cases were found with leakage of cerebrospinal and were cured by lowering the intracra- nial hypertension, posture nursing, local pressure and support therapy. One case with pneumonia fever was cured by at- omization to excretory sputum, the nursing of turning back and percussion on back. The score of JOA was increased from（1.22±0.96）seores to （3.76±0.68） scores after surgery, the score of sphincter function was increased from （1.97± 0.52） scores to （2.68±0.46） scores after surery. Conclusion Pertinence of psychological guidance before surgery can improve patient＇s acceptance of surgery as quickly as possible, adapti function, strictly observation of both lower extremities＇ strength and fee vention of leakage of cerebrospinal and deep venous thrombosis of the successful rate of surgery and promote patient＇s recovery. ve training before surgery, improving respiratory ling changes, posture and recovery training, pre- lower extremity all can signifcangtly improve the