脊柱侧凸病人矫形术后首次下床活动时间影响因素的单因素分析
|
摘要
目的观察脊柱侧凸病人矫形术后首次下床活动时间并分析其影响因素。方法 2016年8月至2017年7月采用便利抽样方法选择在我院行脊柱矫形术的病人58例。男18例,女40例;年龄为(15.14±3.39)岁(7~22岁);脊柱侧凸类型:特发性脊柱侧凸36例,先天性脊柱侧凸10例,神经肌肉型脊柱侧凸12例;Cobb角为54.87°±14.26°。收集病人的一般资料、脊柱侧凸类型、术中情况、术后情况和病人术后首次下床活动时间,并分析术后首次下床活动时间的影响因素。结果本组58例脊柱侧凸病人矫形术后首次下床活动时间为(5.34±1.19)d;术中出血量、术后疼痛情况、术后是否呕吐为影响脊柱侧凸病人术后首次下床活动时间的因素(P均<0.001)。结论在对脊柱侧凸病人进行术后护理时,要根据病人的身体体质、疼痛及术后并发症情况确定病人的首次下床活动时间,适时适当地指导病人下床活动,加速病人康复。
Objective To observe the first out-of-bed activity time of scoliosis patients afterorthopaedic surgery and analyze the influencing factors. Methods Fifty-eight patients undergoing spinalorthopaedic surgery in our hospital from August 2016 to July 2017 were selected by convenient samplingmethod. There were 18 males and 40 females with age of(15.14±3.39) years(7-22 years). For types of scoliosis,there were 36 cases of idiopathic scoliosis, 10 cases of congenital scoliosis, and 12 cases of neuromuscularscoliosis. Cobb angle was 54.87°±14.26°. General information, scoliosis type, intraoperative condition, post-operative condition and the first out-of-bed activity time after operation were collected. Results The first out-of-bed activity time of 58 patients after orthopaedic surgery was(5.34±1.19) days. Intraoperative bleeding volume,postoperative pain and vomiting were the factors influencing the first out-of-bed activity time of scoliosispatients(P<0.001 for all). Conclusion In the postoperative nursing of scoliosis patients, the time of first out-of-bed should be determined according to the patient.s body constitution, pain and complications. The timelyand appropriate guidance of the patient out-of-bed activities can help to accelerate the recovery.
Objective To observe the first out-of-bed activity time of scoliosis patients afterorthopaedic surgery and analyze the influencing factors. Methods Fifty-eight patients undergoing spinalorthopaedic surgery in our hospital from August 2016 to July 2017 were selected by convenient samplingmethod. There were 18 males and 40 females with age of(15.14±3.39) years(7-22 years). For types of scoliosis,there were 36 cases of idiopathic scoliosis, 10 cases of congenital scoliosis, and 12 cases of neuromuscularscoliosis. Cobb angle was 54.87°±14.26°. General information, scoliosis type, intraoperative condition, post-operative condition and the first out-of-bed activity time after operation were collected. Results The first out-of-bed activity time of 58 patients after orthopaedic surgery was(5.34±1.19) days. Intraoperative bleeding volume,postoperative pain and vomiting were the factors influencing the first out-of-bed activity time of scoliosispatients(P<0.001 for all). Conclusion In the postoperative nursing of scoliosis patients, the time of first out-of-bed should be determined according to the patient.s body constitution, pain and complications. The timelyand appropriate guidance of the patient out-of-bed activities can help to accelerate the recovery.
引文
[1]Ng SY, Bettany-Saltikov J. Imaging in the diagnosis and monitoringof children with idiopathic scoliosis[J]. Open Orthop J, 2017, 29(11):1500-1520.
[2]Weiss HR, Moramarco M. The changing paradigm in the manage-ment of spinal deformities[J]. Open Orthop J, 2017, 29(11):1449-1451.
[3]Yaman O, Dalbayrak S. Idiopathic scoliosis[J]. Turk Neurosurg,2014, 24(5):646-657.
[4]Netto MB, Barranco ABS, Oliveira KWK, et al. Influence of anxietyand depression symptoms on the quality of life in patients undergo-ing lumbar spine surgery[J]. Rev Bras Ortop, 2017, 53(1):38-44.
[5]陈亚萍.脊柱侧弯患者术后短期留置尿管期间夹闭尿管效果的研究[D].北京协和医学院中国医学科学院, 2013.
[6]Bettany-Saltikov J, Turnbull D, Ng SY, et al. Management of spinaldeformities and evidence of treatment effectiveness[J]. Open Or-thop J, 2017, 29(11):1521-1547.
[7]Simon MJK, Halm HFH, Quante M. Perioperative complications af-ter surgical treatment in degenerative adult de novo scoliosis[J].BMC Musculoskelet Disord, 2018, 19(1):10.
[8]Cloake T, Gardner A. The management of scoliosis in children withcerebral palsy:a review[J]. J Spine Surg, 2016, 2(4):299-309.
[9]陈艳.特发性脊柱侧弯的护理体会[J].护士进修杂志, 2013, 28(8):723-726.
[10]陈亚萍,梁艳彩.脊柱侧弯患者术后腹胀的观察及其影响因素分析[J].护理学杂志, 2011(18):48-49.
[11]李小金,曾丽雯,韩秀兰,等.渐进式康复护理模式在重度脊柱侧凸行矫正术后患者中的应用[J].中国康复医学杂志, 2015,30(10):1046-1048.
[12]常敏,蔡娟,刘哲,等.疼痛评估及护理对膝关节置换术患者术后活动能力的影响[J].国际护理学杂志, 2017, 36(10):1340-1342.
[13]Isaacs RE, Hyde J, Goodrich JA, et al. A prospective, nonrandom-ized, multicenter evaluation of extreme lateral interbody fusion forthe treatment of adult degenerative scoliosis:perioperative out-comes and complications[J]. Spine(Phila Pa 1976), 2010, 35(26Suppl):322-330.
[14]刘林,许勤,陈丽.胃肠术后患者首次下床活动状况及其影响因素分析[J].护理学杂志, 2013, 28(4):17-19.
[2]Weiss HR, Moramarco M. The changing paradigm in the manage-ment of spinal deformities[J]. Open Orthop J, 2017, 29(11):1449-1451.
[3]Yaman O, Dalbayrak S. Idiopathic scoliosis[J]. Turk Neurosurg,2014, 24(5):646-657.
[4]Netto MB, Barranco ABS, Oliveira KWK, et al. Influence of anxietyand depression symptoms on the quality of life in patients undergo-ing lumbar spine surgery[J]. Rev Bras Ortop, 2017, 53(1):38-44.
[5]陈亚萍.脊柱侧弯患者术后短期留置尿管期间夹闭尿管效果的研究[D].北京协和医学院中国医学科学院, 2013.
[6]Bettany-Saltikov J, Turnbull D, Ng SY, et al. Management of spinaldeformities and evidence of treatment effectiveness[J]. Open Or-thop J, 2017, 29(11):1521-1547.
[7]Simon MJK, Halm HFH, Quante M. Perioperative complications af-ter surgical treatment in degenerative adult de novo scoliosis[J].BMC Musculoskelet Disord, 2018, 19(1):10.
[8]Cloake T, Gardner A. The management of scoliosis in children withcerebral palsy:a review[J]. J Spine Surg, 2016, 2(4):299-309.
[9]陈艳.特发性脊柱侧弯的护理体会[J].护士进修杂志, 2013, 28(8):723-726.
[10]陈亚萍,梁艳彩.脊柱侧弯患者术后腹胀的观察及其影响因素分析[J].护理学杂志, 2011(18):48-49.
[11]李小金,曾丽雯,韩秀兰,等.渐进式康复护理模式在重度脊柱侧凸行矫正术后患者中的应用[J].中国康复医学杂志, 2015,30(10):1046-1048.
[12]常敏,蔡娟,刘哲,等.疼痛评估及护理对膝关节置换术患者术后活动能力的影响[J].国际护理学杂志, 2017, 36(10):1340-1342.
[13]Isaacs RE, Hyde J, Goodrich JA, et al. A prospective, nonrandom-ized, multicenter evaluation of extreme lateral interbody fusion forthe treatment of adult degenerative scoliosis:perioperative out-comes and complications[J]. Spine(Phila Pa 1976), 2010, 35(26Suppl):322-330.
[14]刘林,许勤,陈丽.胃肠术后患者首次下床活动状况及其影响因素分析[J].护理学杂志, 2013, 28(4):17-19.