本文選題：無骨折脫位型頸脊髓損傷 + 椎管擴(kuò)大成形術(shù)　； 參考：《實(shí)用醫(yī)學(xué)雜志》2017年03期

【摘要】：目的:探討康復(fù)護(hù)理對(duì)無骨折脫位型頸脊髓損傷患者椎管擴(kuò)大成形術(shù)后的預(yù)后影響。方法:將收治的28例無骨折脫位型頸脊髓損傷患者作為研究對(duì)象,在進(jìn)行椎管擴(kuò)大成形術(shù)后,予以早期頸部及四肢功能鍛煉。結(jié)果:手術(shù)前患者的神經(jīng)功能損傷情況按JOA評(píng)分法評(píng)分4~10分,平均5分。術(shù)后隨訪8~20個(gè)月,平均13個(gè)月,患者的Frankel分級(jí)獲得改善:6例在術(shù)前評(píng)級(jí)為B級(jí)的患者進(jìn)步為C級(jí),12例術(shù)前評(píng)級(jí)為C級(jí)者進(jìn)步為D級(jí),2例D級(jí)進(jìn)步到E級(jí)。神經(jīng)功能改善達(dá)優(yōu)8例、良16例、可2例、差2例;隨訪結(jié)束時(shí)JOA評(píng)分平均為11.5分。頸部疼痛明顯改善,未發(fā)生明顯頸椎后凸畸形。無內(nèi)固定松脫、斷裂等并發(fā)癥發(fā)生。結(jié)論:對(duì)無骨折脫位型頸脊髓損傷椎管擴(kuò)大成形術(shù)后患者行早期頸部及四肢早期康復(fù)鍛煉,可有效減輕頸椎術(shù)后疼痛,避免術(shù)后頸椎后凸畸形,有利于四肢功能的恢復(fù)。
[Abstract]:Objective: to explore the effect of rehabilitation nursing on the prognosis of patients with cervical spinal cord injury without fracture and dislocation. Methods: Twenty-eight patients with cervical spinal cord injury without fracture and dislocation were studied. Results: the neurological function injury of the patients before operation was assessed by JOA scoring method, with an average score of 5 points. Follow-up for 8 ~ 20 months (mean 13 months) showed that the Frankel grade of 6 patients with preoperative grade B was improved to that of grade C 12 patients with preoperative grade C advanced to grade D of 2 patients with grade D to grade E. The neurological function was improved in 8 cases, good in 16 cases, fair in 2 cases and poor in 2 cases. The average JOA score was 11.5 at the end of follow-up. Cervical pain was significantly improved and no apparent cervical kyphosis occurred. No internal fixation loosening, rupture and other complications occurred. Conclusion: early rehabilitation exercises for patients with cervical spinal cord injury without fracture and dislocation can effectively reduce postoperative pain, avoid postoperative kyphosis, and be beneficial to the recovery of limb function.
【作者單位】： 開平市中心醫(yī)院骨外科;
【分類號(hào)】：R473.6

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