段少华 齐秀会 周治国

摘要：目的  探讨康复护理对无骨折脱位型颈脊髓损伤患者椎管扩大成形术后的影响。方法  选取2018年1月～6月于我院行手术的无骨折脱位型颈脊髓损伤患者60例作为研究对象，按照随机数表法分为研究组和对照组，每组30例。研究组采用康复护理进行术后护理，对照组采用常规护理。比较两组患者术后神经功能改善情况和并发症发生率。结果  研究组颈部神经功能改善的优良率为80.00%，高于对照组的60.00%，差异有统计学意义（P<0.05）;研究组术后并发症发生率为10.00%，低于对照组的23.33%，差异有统计学意义（P<0.05）。结论  康复护理能够促进无骨折脱位型颈脊髓损伤患者椎管扩大成形术后的神经功能恢复，减少术后并发症发病几率。

关键词：无骨折脱位型颈脊髓损伤;椎管扩大成形手术;康复护理

Abstract：Objective  To explore the effect of rehabilitation nursing on the operation of spinal canal enlargement in patients with cervical spinal cord injury without fracture and dislocation. Methods  60 patients with cervical spinal cord injury without fracture and dislocation were enrolled in our hospital from January to June 2018. The patients were divided into study group and control group according to the random number table method， 30 cases in each group. The study group used rehabilitation care for postoperative care， while the control group received routine care. The improvement of postoperative neurological function and the incidence of complications were compared between the two groups. Results  The excellent and good rate of cervical nerve function improvement in the study group was 80.00%， which was higher than that of the control group 60.00%，the difference was statistically significant （P<0.05）. The postoperative complication rate was 10.00% in the study group，the difference was 23.33% lower than the control group，the difference was statistically significant （P<0.05）. Conclusion  Rehabilitation nursing can promote the recovery of neurological function after spinal canal enlargement in patients with cervical spinal cord injury without fracture and dislocation， and reduce the incidence of postoperative complications.

Key words：Cervical spinal cord injury without fracture and dislocation;Spinal canal enlargement surgery;Rehabilitation nursing

無骨折脱位型颈髓损伤（cervical spinal cord injury without fracture dislocation），也被称为无放射学影像异常颈髓损伤，即损伤部位无法通过X线或者CT等放射学检查发现，属于颈髓的间接损伤。无骨折脱位型颈脊髓损伤多见于原有颈椎退变，或先天性、发育性或退变性颈椎管狭窄、颈椎OPLL或先天性颈椎畸形等原有颈椎病变者，受到外力后可导致颈脊髓损伤并出现相应临床症状，无骨折脱位型颈髓损伤往往外伤的暴力程度较轻，脊髓损伤程度多为不完全性损伤[1]。对于该类损伤，多选用椎管扩大成形手术，目的是解除脊髓压迫，恢复颈椎合理曲度，重建颈椎的稳定性。虽然手术治疗取得了较高的治疗价值，但术后能够尽早开展功能康复锻炼，可进一步改善生活质量，快速稳定病情，直接影响预后效果，因此如何选择有效护理干预至关重要[2]。随着护理事业的完善发展，既往常规护理已经无法获得满意效果，临床认为康复护理效果更好，促进颈部神经功能迅速改善，为患者更好地恢复健康提供前提。……