CAJ | 학술논문

目的探讨硬膜外腔导管松解联合神经根孔外韧带剥离治疗腰椎管狭窄症的护理方法.方法对收治的36例行硬膜外腔导管松解联合神经根孔外韧带剥离术患者术前给予全面的心理疏导、体位训练,术后给予常规护理和专科护理,观察相关护理对患者康复的作用及效果,采用Oswestry功能障碍指数(ODI)评价临床疗效.结果 36例患者术后ODI获得明显改善,根据ODI改善率得出的手术临床效果:优13例(36.1％),良17例(47.2％),可3例(8.3％),差3例(8.3％),优良率为83.3％.未发生感染、硬膜外血肿、术中大出血等并发症.结论经皮、经骶管行硬膜外腔导管松解,精确药物注射,选择性联合应用神经根孔外韧带剥离技术,可以有效缓解腰椎管狭窄症所致腰腿痛症状；术前、术后给予正确、恰当的护理能很好地改善椎管狭窄,避免并发症的发生,提高手术成功率.
목적 탐토경막외강도관송해연합신경근공외인대박리치료요추관협착증적호리방법.방법 대수치적36례행경막외강도관송해연합신경근공외인대박리술환자술전급여전면적심리소도、체위훈련,술후급여상규호리화전과호리,관찰상관호리대환자강복적작용급효과,채용Oswestry공능장애지수(ODI)평개림상료효.결과 36례환자술후ODI획득명현개선,근거ODI개선솔득출적수술림상효과:우13례(36.1％),량17례(47.2％),가3례(8.3％),차3례(8.3％),우량솔위83.3％.미발생감염、경막외혈종、술중대출혈등병발증.결론 경피、경저관행경막외강도관송해,정학약물주사,선택성연합응용신경근공외인대박리기술,가이유효완해요추관협착증소치요퇴통증상；술전、술후급여정학、흡당적호리능흔호지개선추관협착,피면병발증적발생,제고수술성공솔.
Objective To investigate the postoperative care for patients with spinal stenosis who underwent adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection and caudal epidural injections.Methods Special care such as psychotherapy,posture training,routine nursing and so on were adopted for 36 cases during the operation of adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection and caudal epidural injections,and the effects and results of patients' rehabilitation were observed.Results Among 36 patients,they achieved satisfactory clinical results and postoperative Oswestry Disability Index (ODI) significantly were improved with 13 cases very good,17cases good,3 cases not bad,and 3 caes poor.No severe surgery complications such as infection,epidural hematoma,blood bleeding occurred.Conclusions Percutaneous epidural adhesiolysis combining selective percutaneous extraforaminotomy with foraminal ligament resection may be effective in patients with chronic low back and lower extremity pain secondary to lumbar spinal stenosis.Complications of surgery could be prevented,recovery time could be shortened,and success rate could be enhanced by giving the accurate and proper care during the operation.