CAJ | 학술논문

目的：探讨应用布带上提法结合经皮椎体后凸成型术（PKP）治疗重度椎体压缩性骨折的围手术期护理措施。方法应用布带上提法结合PKP术治疗重度椎体压缩性骨折28例。术前作好心理护理、合并症的处理、专科器械准备等外，应用布带条兜着患者椎体骨折后凸处上提，使脊柱极度过伸纠正部分脊柱后凸畸形；术中与操作医师紧密配合，术后严密观察生命体征变化、并发症的发生及疗效观察。结果28例患者均顺利完成手术，术后6～8h疼痛迅速缓解，术后1～2d均能下床活动。椎体高度由术前（7.9±0.3）cm 增加至术后第3d（15.2±0.25）cm，COBB角由术前31°±2.80°矫正至术后18.20°±2.7°， VAS 评分由术前（7.1±1.36）分降至术后第3d（1.20±0.90）分，各项目差异均有显著性（P＜0.01）。骨水泥漏2例，一例为椎间盘漏，一例椎体侧方漏。无严重并发症的发生。结论布带上提法结合PKP术是一种较为简单、安全、损伤小的治疗重度椎体压缩性骨折的有效方法，在止痛和纠正脊柱后凸畸形方面具有肯定的效果。科学的围手术期护理是提高手术成功率、减少并发症的重要保证。
목적：탐토응용포대상제법결합경피추체후철성형술（PKP）치료중도추체압축성골절적위수술기호리조시。방법응용포대상제법결합PKP술치료중도추체압축성골절28례。술전작호심리호리、합병증적처리、전과기계준비등외，응용포대조두착환자추체골절후철처상제，사척주겁도과신규정부분척주후철기형；술중여조작의사긴밀배합，술후엄밀관찰생명체정변화、병발증적발생급료효관찰。결과28례환자균순리완성수술，술후6～8h동통신속완해，술후1～2d균능하상활동。추체고도유술전（7.9±0.3）cm 증가지술후제3d（15.2±0.25）cm，COBB각유술전31°±2.80°교정지술후18.20°±2.7°， VAS 평분유술전（7.1±1.36）분강지술후제3d（1.20±0.90）분，각항목차이균유현저성（P＜0.01）。골수니루2례，일례위추간반루，일례추체측방루。무엄중병발증적발생。결론포대상제법결합PKP술시일충교위간단、안전、손상소적치료중도추체압축성골절적유효방법，재지통화규정척주후철기형방면구유긍정적효과。과학적위수술기호리시제고수술성공솔、감소병발증적중요보증。
Objective to explore the application of hyperextension position and percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures. Methods Applications hyperextension position and percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in 28 cases. Preoperative make psychological care, complications of treatment, specialist equipment ready endures, the application cloth strips bear mentioning on vertebral fractures in patients with kyphosis at the spine of extreme hyperextension corrective part of kyphosis; surgery operation the physician closely with, and after close observation of changes in vital signs, and the incidence of complications and efficacy. Results 28 cases were successful y surgery, postoperative 6~8h quickly relieve pain after 1~ 2d able to get out of bed. Vertebral height from preoperative (7.9 ± 0.3) cm increase after 3d (15.2 ± 0.25) cm, COBB angle correction from preoperative 31 ° ± 2.80° to of Postoperative 18.20 ° ± 2.7 ° , the VAS score from preoperative (7.1 ± 1.36) points down after 3d (1.20±0.90) points, and the differences were statistical y significant (P <0.01) in each project. Bone cement leakage in 2 cases, and one intervertebral disc leakage, one case of vertebral side leakage. No serious complications occurred. Conclusions hyperextension position and percutaneous kyphoplasty is a relatively simple, safe, injury treatment of severe vertebral compression fractures effective method, has a positive effect in analgesic and correct kyphosis. Important to ensure scientific preoperative care is to improve the success rate of surgery, reduce complications.