中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2010年
23期
2750-2751
,共2页
颈椎管狭窄症%单开门椎管扩大成形术%Centerpiece钢板%手术配合
頸椎管狹窄癥%單開門椎管擴大成形術%Centerpiece鋼闆%手術配閤
경추관협착증%단개문추관확대성형술%Centerpiece강판%수술배합
Cervical spinal canal stenosis%Single open-door laminoplasty%Centerpiece plate%Surgical care
目的 总结颈3～7单开门椎管扩大椎板成形Centerpiece钢板(颈椎后路椎板成形钢板螺钉内固定系统)内固定术的手术配合及护理特点.方法 回顾我院脊柱外科对19例颈椎管狭窄患者行后路颈3～7单开门椎管扩大椎板成形Centerpiece钢板内同定术,对术前动力系统的准备、手术体位、头架的安放,术中开门和钢板内固定过程中涉及的器械、动力系统的使用等问题进行探讨和总结.结果19例经后路颈3～7单开门椎管扩大椎板成形Centerpiece钢板内固定术患者手术顺利,无一例因体位和动力系统原因影响手术进程.手术时间95～130 min,平均时间105 min,术中平均出血量290 ml,术中C臂透视证实Centerpiece钢板位置良好,术后除1例出现脑积液漏,7例出现颈肩部轻度疼痛伴有酸胀、僵硬症状外,未出现脊髓损伤、血肿等并发症.术后1～6个月随访,未发现螺钉固定不稳、松动、钢板移位、再关门等现象,患者神经功能恢复良好.结论 单开门颈椎管扩大椎板成形Centerpiece钢板内固术是目前治疗颈椎管狭窄症较好的一种手术方式.掌握Mayfield头架的使用,摆放好体位,熟悉手术步骤,准备和使用好动力系统有助于该手术的顺利完成.
目的 總結頸3～7單開門椎管擴大椎闆成形Centerpiece鋼闆(頸椎後路椎闆成形鋼闆螺釘內固定繫統)內固定術的手術配閤及護理特點.方法 迴顧我院脊柱外科對19例頸椎管狹窄患者行後路頸3～7單開門椎管擴大椎闆成形Centerpiece鋼闆內同定術,對術前動力繫統的準備、手術體位、頭架的安放,術中開門和鋼闆內固定過程中涉及的器械、動力繫統的使用等問題進行探討和總結.結果19例經後路頸3～7單開門椎管擴大椎闆成形Centerpiece鋼闆內固定術患者手術順利,無一例因體位和動力繫統原因影響手術進程.手術時間95～130 min,平均時間105 min,術中平均齣血量290 ml,術中C臂透視證實Centerpiece鋼闆位置良好,術後除1例齣現腦積液漏,7例齣現頸肩部輕度疼痛伴有痠脹、僵硬癥狀外,未齣現脊髓損傷、血腫等併髮癥.術後1～6箇月隨訪,未髮現螺釘固定不穩、鬆動、鋼闆移位、再關門等現象,患者神經功能恢複良好.結論 單開門頸椎管擴大椎闆成形Centerpiece鋼闆內固術是目前治療頸椎管狹窄癥較好的一種手術方式.掌握Mayfield頭架的使用,襬放好體位,熟悉手術步驟,準備和使用好動力繫統有助于該手術的順利完成.
목적 총결경3～7단개문추관확대추판성형Centerpiece강판(경추후로추판성형강판라정내고정계통)내고정술적수술배합급호리특점.방법 회고아원척주외과대19례경추관협착환자행후로경3～7단개문추관확대추판성형Centerpiece강판내동정술,대술전동력계통적준비、수술체위、두가적안방,술중개문화강판내고정과정중섭급적기계、동력계통적사용등문제진행탐토화총결.결과19례경후로경3～7단개문추관확대추판성형Centerpiece강판내고정술환자수술순리,무일례인체위화동력계통원인영향수술진정.수술시간95～130 min,평균시간105 min,술중평균출혈량290 ml,술중C비투시증실Centerpiece강판위치량호,술후제1례출현뇌적액루,7례출현경견부경도동통반유산창、강경증상외,미출현척수손상、혈종등병발증.술후1～6개월수방,미발현라정고정불은、송동、강판이위、재관문등현상,환자신경공능회복량호.결론 단개문경추관확대추판성형Centerpiece강판내고술시목전치료경추관협착증교호적일충수술방식.장악Mayfield두가적사용,파방호체위,숙실수술보취,준비화사용호동력계통유조우해수술적순리완성.
Objective To summarize the C3～7 the single cervical open-door laminoplasty with Centerpiece plate ( posterior cervical laminoplasty plate and screw fixation system) internal fixation surgery and nursing characteristics. Methods The surgeries in our hospital from August 2009 to January 2010 was investigate, which were 19 cases of cervical stenosis with posterior C3～7 single cervical open-door laminoplasty and Centerpiece plate fixation. The focused process was discussed, such as preoperative dynamic systems preparation, surgical position, the frame of the placement and intraoperative open the door and plate fixation device. Results 19 cases of posterior C3～7 single cervical open-door laminoplasty and Centerpiece plate fixation surgeries were uneventful and none of the reason for body position and power systems affected the surgical process. Operative time was 95～130 minutes, with an average time of 105 minutes; intraoperative blood loss was 290 ml; intraoperative C-arm X-ray confirmed Centerpiece plate in a good position. However, 1 patient appeared cerebral fluid leakage after operation and 7 patients appeared mild pain in the shoulder and neck accompanied by stiffness symptoms. There were no spinal cord injuries and complications such as hematoma. After 1 to 6 months follow-up there were no screw fixation instability, loosening, plate shift, and lamina phenomena occurred and the neurological function in patients recovered well. Conclusions The single cervical open-door cervical laminoplasty with Centerpiece plate technique is the better treatment of cervical stenosis as a surgical method. Mastering the use of Mayfield head frame, displaying good posture, getting a good knowledge of surgical procedures, preparing and using well the power system contribute to the operation completed successfully.
