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目的探讨使用椎间孔镜治疗腰椎间盘突出症患者的护理方法。方法捜集并分析2013年7月-2015年7月在天津市第四医院使用椎间孔镜治疗的腰椎间盘突出症患者的病历资料35例。结果所有腰椎间盘突出症患者术前诊断明确术中顺利进行安返病房术后卧床休息2 d第3天下地活动第5~7天好转出院第10~12天拆线,住院期间无护理相关并发症,术前根据患者的视觉模拟评分表(VAS)进行评分为(3.38±1.60)分,术后为(2.15±0.30)分差异有统计学意义(P<0.05)。患者18个月后改良Macnab疗效评定结果,优27例良5例,可3例,优良率达到91.40%,与术前比较差异有统计学意义(P<0.05)。结论使用椎间孔镜对腰椎间盘突出症患者进行微创手术,疗效明显。并且此手术还具有创伤小、出血少、手术时间短、住院周期短、安全可靠、恢复满意等优点。同时术前给予患者耐心的心理辅导、合理的术前训练,可减轻患者精神负担;术后科学的功能锻炼和精心的护理可提高患者手术的效果。
Objective To investigate the nursing methods of patients with lumbar disc herniation using intervertebral disc mirror. Methods 捜 Clinical data of 35 patients with lumbar disc herniation underwent transforaminal endoscopic surgery in the Fourth Hospital of Tianjin City from July 2013 to July 2015 were collected and analyzed. Results All patients with lumbar disc herniation had a clear preoperative diagnosis and had a good postoperative ambulation in Anshospital ward. The patients were placed in bed for rest for 2 days on the third day. The 5th to 7th days were removed and the stitches were removed on the 10th to 12th days. The preoperative score was (3.38 ± 1.60) according to the visual analogue scale (VAS), and the difference was statistically significant (2.15 ± 0.30) after operation (P <0.05). After 18 months, the results of modified Macnab evaluation were excellent in 27 cases, good in 5 cases and fair in 3 cases. The excellent and good rate was 91.40%. There was significant difference between the two groups (P <0.05). Conclusion The use of intervertebral disc in patients with lumbar disc herniation minimally invasive surgery, the effect is obvious. And this operation also has the advantages of less trauma, less bleeding, shorter operation time, shorter hospital stay, safety and reliability, recovery and so on. Preoperative patient psychological counseling, reasonable preoperative training, can reduce the mental burden of patients; postoperative scientific exercise and meticulous care can improve the operation of the patient’s effect.