丹参预防颈椎术后脊髓缺血再灌注损伤的临床观察及护理

目的:探讨丹参预防颈椎术后脊髓缺血再灌注损伤(SCIRI)的临床效果和护理方法。方法:回顾性分析我院2009年1月—2013年12月386例行上颈椎手术患者的临床资料,按照入院先后顺序不同分入两组,观察组198例于术前静脉滴注20m L丹参注射液(用5%葡萄糖注射液250m L稀释后使用),术后每日静脉滴注20m L丹参注射液(用5%葡萄糖注射液250m L稀释后使用),治疗10d,对照组188例于术后三天静脉滴注40mg甲强龙,所有患者均予以相应的护理措施,比较两组术后SCIRI发生率,脊髓型颈椎病(JOA)评分及JOA评分改善率情况。结果:所有368例患者中,SCIRI发生率为2.2%(8/368),观察组SCIRI发生率0.5%(1/198)显著高于对照组3.7%(7/188),观察组术后JOA评分(13.7±2.4)分显著高于对照组(13.2±2.3)分,改善率(61.7±2.8)%显著高于对照组(61.2±2.7)%,差异均具有统计学意义(均P<0.05)。结论:丹参有效预防上颈椎术后SCIRI,保护脊髓组织和功能,改善JOA评分,促进脊髓功能恢复,加之合理的护理措施,改善生活质量。

Clinical Observation and Nursing on Salvia Miltiorrhiza on Prevention of Postoperative Cervical Spinal Cord Ischemia -Reperfusion Injury

Objective ： To study the clinical effect and nursing methods of salvia miltiorrhiza on prevention of postoperative cervical spinal cord ischemia - reperfusion injury （SCIRI）. Methods ：A retrospective analysis in January 2009 - December 2013 was carried out. 386 patients who underwent cervical spine surgery in order according to the hospital, different points were divided into two groups, 198 cases in observation group（ preoperative intravenous drip 20 mL of salvia miltiorrhiza injection, diluted by 5% Glucose Injection 250 mL after use） and postoperative intravenous drip 20 mL of salvia miltiorrhiza injection20 mL of salvia miltiorrhiza injection,the treatment of 10 d）and the control group 188 cases（ after three days of intravenous infusion of 40 mg Sou Medrol）. All patients were given corresponding nursing measures. We compared two groups＇ incidence of postoperative SCIRI myelopathic type, cervical spondylosis （JOA） score and JOA score period. Results：Among all 368 patients, the incidence was 2. 2% （8/368）. The observation group＇s SCIRI rate 0. 5% （1/198） was significantly higher than that of control group 5.7% （7/185）. The observation group＇ s postoperative JOA score （ 13.7± 2.4 ） points was significantly higher than that of the control group （ 13.2 ±2. 3 ）. The improvement （61. 7 ± 2. 8） % was significantly higher than that of the control group （61.2 ± 2. 7） % and the differences were statistically significant （ all P 〈 0. 05 ）. Conclusion ： The salvia miltiorrhiza is effective on prevention of postoperative cervical spine SCIRI. It can protect spinal cord tissue and function,improve the JOA score and promote the function recovery of spinal cord. Combined with reasonable nursing measures, it can improve the quality of life.