| 佟静,刘宝戈,王琳,等.颈椎前路术后并发脑脊液漏的早期规范离床效果：单中心连续对照护理研究.骨科,2020,11(5): 441-445. |
| 颈椎前路术后并发脑脊液漏的早期规范离床效果：单中心连续对照护理研究 |
| Early out-of-bed mobilization of cerebrospinal fluid leakage after anterior cervical surgery: a single center continuous controlled nursing study |
| 投稿时间：2020-07-09 |
| DOI：10.3969/j.issn.1674-8573.2020.05.018 |
| 中文关键词: 颈椎术后 脑脊液漏 早期离床 |
| 英文关键词: After cervical surgery Cerebrospinal fluid leakage Early out of bed |
| 基金项目:院青年护理专项（2020-YQN-10）；国家自然科学基金（81972084） |
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| 中文摘要: |
| 目的 探讨颈椎前路术后发生脑脊液漏（cerebrospinal fluid leakage, CSFL）病人早期规范离床的安全性及可行性。方法 回顾性分析2018年1月至2019年12月在我院骨科诊断为颈椎病并行颈椎前路椎间盘切除减压植骨融合术（ACDF）或颈椎前路椎体次全切除植骨融合术（ACCF）后发生脑脊液漏的11例病人的临床资料。将2018年1月至2018年12月采取传统护理保守离床时间及方式的4例纳入对照组；2019年1月至2019年12月有效实施护理计划并制定早期规范离床方案的7例纳入观察组。观察两组病人住院时间、术后并发症发生情况、离床时间和病人疗效满意度（Odom评分）。结果 两组病人均未出现伤口不愈合、硬脊膜囊肿及神经系统感染等并发症，随访时间为6~18个月。观察组住院时间和离床时间分别为9.0（1.0） d和4.0（2.0） d，均短于对照组的13.0（3.0） d和8.0（0.75） d，差异均有统计学意义（P均＜0.05）。观察组术后发生体位性低血压1例（1/7，14.3%）及肺部感染0例，均明显低于对照组的2例（2/4，50.0%）和2例（2/4，50.0%），差异均有统计学意义（P均＜0.05）。出院时，观察组的Odom疗效满意度为98.0%，高于对照组的92.5%，差异有统计学意义（P＜0.05）。结论 优化护理管理策略并采取早期规范离床对颈椎前路术后并发脑脊液漏病人安全可行。 |
| 英文摘要: |
| Objective To investigate the safety and feasibility of early standardized off-bed activities in patients with cerebrospinal fluid leakage (CSFL) after anterior cervical spine surgery. Methods The clinical data of 11 patients with CSFL after anterior cervical decompression and fusion from January 2018 to December 2019 in our hospital were retrospectively analyzed. From January 2018 to December 2018, 4 patients who took conservative off-bed time and method of traditional nursing care were included in the control group; and 7 cases from January 2019 to December 2019 who effectively implemented the nursing plan and formulated early standardized out of bed program were included in the observation group. The length of hospital stay, postoperative complications, time of leaving bed and the degree of satisfaction (Odom score) of the two groups were observed. Results No wound nonunion, dural cyst and nervous system infection occurred in both groups. The follow-up time was 6-18 months. At the time of discharge, the satisfaction of Odom effect in the observation group was 98.0%, which was significantly higher than that in the control group (92.5%, P＜0.05); the hospitalization time and out of bed time in the observation group were 9.0(1.0) d and 4.0(2.0) d respectively, which were shorter than 13.0(3.0) d and 8.0(0.75) d respectively in the control group, and the differences were statistically significant (P＜0.05). In the observation group, 1 case (1/7, 14.3%) of postural hypotension and 0 case of pulmonary infection occurred, and 2 cases (2/4, 50%) and 2 cases (2/4, 50%) respectively in the control group, and the differences were statistically significant (all P＜0.05). Conclusion It is safe and feasible for patients with CSFL after anterior cervical spine surgery to optimize nursing management strategy and take early standard off bed. |
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