近年来,随着医疗体制改革及护理学科的发展,建立一支既适应我国社会发展,又满足广大人民群众健康需求的高素质护理队伍,是护理管理者面临的一个重要课题[1].随着医学模式的转变,护士的工作逐渐转变为护理服务的教育咨询者和健康生活方式的倡导者[2].而实习护生无疑是护理队伍的生力军,也是护理人才的新鲜血液,因此,做好实习护生的临床带教工作意义重大.
[目的]研究经右侧颈前路切口清理结核自取髂骨植骨前路钛板固定治疗颈椎结核的手术方法、疗效及5年随访结果.[方法]收集2008年4月～2013年4月全部采用右侧颈前路病灶清除自体髂骨植骨内固定治疗颈椎结核病例,共10例,平均31岁.C45例,C53例,C62例.所有病例均采用一期病灶清除髂骨植骨内固定术,抗结核治疗9～12个月.[结果]平均随访30个月.颈椎生理弧度得以恢复,术后随访未见矫正角度明显丢失;神经功能恢复良好;术后3～6个月植骨融合,内固定器械无断裂,无结核病灶局部复发.[结论]在抗痨治疗的基础上,右侧颈前路手术清除结核病灶取髂骨钛板固定治疗中下颈椎结核,恢复病灶破坏椎体的高度、同时达到矫正后凸畸形的目的、解除结核病灶对脊髓神经的压迫、重建颈椎的稳定,有利于结核病灶的愈合.
Objective To discuss the clinical effect of simple posterior distraction and reduction for thoracolumbar burst fracture. Methods A total of 15 patients with thoracolumbar burst fracture enrolled in hospital from February 2012 to February2013 were without expression of spinal cord and cauda equina injury by preoperative physical examination and electromyography(EMG). Simple posterior distraction reduction and internal fixation was adopted and structure simple posterior distraction was used to restore the vertebral height and avoid injuring cauda equina and nerve root again without decompressing spinal canal indirectly. Results 15 patients were followed up for 3-36 months with average of 18 months,no vascular and neurological complications,broken nails,screws loosening and nonunion occurred. Conclusion After postoperative reexamination of the 15patients,the vertebral height restore satisfactorily,Cobb angle of kyphosis decrease significantly,all patients are fracture reduction with vertebral canal volume recovered or mostly recovered,and neural functional recovery is better,which show that the posterior distraction reduction fixation for thoracolumbar burst fracture is feasible.
