体外充气复位结合PKP术治疗骨质疏松性胸腰椎压缩性骨折的护理体会

张　静　龙亨国　熊小春　蒋婉妮浙江省舟山市中医院脊柱科，浙江舟山　316000

体外充气复位结合PKP术治疗骨质疏松性胸腰椎压缩性骨折的护理体会

张静龙亨国▲熊小春蒋婉妮
浙江省舟山市中医院脊柱科，浙江舟山316000

目的观察骨质疏松椎体压缩性骨折采用体外充气复位结合经皮椎体后凸成形术（PKP）治疗的护理措施。方法回顾自2012年10月～2014年10月收治的90例骨质疏松椎体压缩性骨折患者，随机分为两组：观察组（采用体外复位+PKP术治疗，n=45）和对照组（单用PKP治疗，n=45）。比较护理前后患者的Barthel指数、视觉模拟评分法评分（VAS）等各项指标。结果手术护理前，观察组Barthel指数为（54.0±1.23），VAS评分为（8.62±1.53）分。对照组手术护理前，Barthel指数为（50.4±1.52），VAS评分为（8.58±1.73）分，差异无统计学意义。但两组患者护理前后及护理后组间在Barthel指数、VAS评分等各项指标比较，差异均有统计学意义（P均＜0.05）。结论体外充气复位结合经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折是临床治疗OVCF的有效微创方法，具有创伤小、术后可早期下地活动、止痛效果良好的优势，能够有效地促进患者术后的康复，提高患者的生活质量。

充气复位；经皮椎体后凸成形术；骨质疏松；压缩性骨折；护理

［Abstract］Objective To observe the nursingmeasures of the postural reduction and percutaneous kyphoplasty of the producing after vertebral plasty（PKP）for thoracolumbar compression fractures.M ethods A total of 90 cases of patients with osteoporotic vertebral compression fractures were given the operativemedical treatment in our hospital during the period form Octcber 2012 to Octcber 2014，they were selected and divided into postural reduction+PKP group（n=45）and PKP group（n=45）by table of random number，the restoration Barthel index，Cobb's angle changes，the incidence of postoperative complications and isual analogue score（VAS）score were observed before and after operation.Results Before surgery nursing in reduction+PKP group，Barthel index was（54.0±1.23），VAS score was（8.62±1.53）score.And in PKP group，Barthel index was（50.4±1.52），VAS score was（8.58±1.73）score，there was no significant differences between two groups.There were all statistically significant differences in Barthel index and VAS score before and after surgery in two groups and after nursing between two groups（allP＜0.05）.Conclusion Combination of hyperextensive reposition and percutaneous kyphoplasty after in vitro localization for the treatment of OVCFmight beminimally invasive，safe and effective to alleviate pain and shorten period of recum-bence，promote patients'rehabilitation and improve quality of life.

［Key words］Postural reduction；PKP；Osteoporosis；Compression fractures；Nursing

根据一项调查结果显示，美国新发骨质疏松性骨折中脊柱骨折，尤其是胸腰椎的椎体压缩性骨折（vertebral compression fracture，VCF）达髋部骨折例数的两倍之多。目前对骨质疏松性椎体压缩骨折患者的治疗，一般采用口服止痛药物、加强腰背肌功能锻炼、佩戴支具、卧床休息等保守方法，但都难以显著而迅速地缓解症状，不能坚持足够的卧床时间而病程过长，后期椎体压缩高度丢失，患者常因为严重的疼痛而丧失生活自理能力或劳动能力，给社会及家庭带来沉重的心理与经济负担。……