颈椎骨折脱位合并颈髓损伤术前观察和护理.docVIP

颈椎骨折脱位合并颈髓损伤术前观察和护理 　　摘要：目的 探讨颈椎骨折脱位合并颈髓损伤患者的观察和有效护理方法，提高颈椎骨折脱位合并颈髓损伤患者的护理水平。方法 分析探讨1例颈椎骨折脱位合并颈髓损伤患者的护理，包括严密观察病情变化，卧硬板床，防止感染，营养支持等护理措施.合并脊髓损伤时，通知医生根据骨折类型和受压部位行必要手术治疗。结果 本例患者经手术治疗治愈出院。结论 严密观察病情变化，采取积极适当的护理措施是有效治疗颈椎骨折脱位合并颈髓损伤患者及提高护理水平的重点。 　　关键词：颈椎骨折脱位；颈髓损伤；观察护理 　　Cervical Fracture Dislocation with Spinal Cord Injury Preoperative Observation and Nursing 　　ZHAO Qin-juan,CAI Mei-fen 　　(Jiangyin City Zhouzhuang Hospital,Jiangyin 214423,Jiangsu,China) 　　Abstract：ObjectiveTo study the cervical spine fracture with cervical spinal injury patients combined observation and effective nursing methods, improve the cervical spine fracture with cervical spinal injury patients combined nursing level. MethodsAnalyzed and 1 case of cervical fracture with cervical spinal injury patients combined care, including observation patients condition carefully, lie the hard bed, prevent infection, the nursing measures such as nutrition support. When merging spinal cord injury, notify the doctor according to the fracture type and line pressure parts needed surgery. ResultsThe patients were cured by surgical treatment. ConclusionThe observation patients condition carefully, positive and appropriate nursing measures are effective treatment for cervical spine fracture dislocation with cervical spinal injury patients and improve the level of care. 　　Key words：Cervical spine fracture dislocation; Cervical spinal injury; The nursing 　　多见于各种原因所致的直接暴力或间接暴力引起的损伤,颈椎骨折患者可有头颈部疼痛,不能活动,损伤部位肿胀,有明显压痛.合并颈髓损伤,病情较严重，患者出现胸闷，气促和呼吸困难，可出现明显的低氧血症症状。随致伤原因,损伤部位和程度不同而异.对颈椎骨折脱位合并颈髓损伤的患者处理应持积极态度。为了减轻患者的痛苦，促进早日康复，本文针对颈椎骨折脱位合并颈髓损伤的病例浅谈术前临床观察和护理体会。 　　1 临床病例 　　患者，男性，52岁，已婚，江苏人,因头部及腰背部跌伤后疼痛2h余而入院。患者于2h前醉酒骑摩托车跌伤，致头颈腰背部等处受伤。当时无昏迷,顿感局部剧烈疼痛，腰背部活动受限,,稍活动即剧痛,无明显出血,无下肢麻木感,无会阴区感觉异常,无胸闷气促，无腹痛、腹胀，无大小便失禁及障碍。急来我院门诊就诊，经B超,CT检查无异常，拟头部外伤收住入院。根据患者病史体征，诊断明确患者受伤以来，大小便正常。体检：体温36.5℃，心率：68次/min，呼吸：22次/min，血压90/71mmHg。鉴别诊断：①肋骨,脊柱骨折：暂时全胸片无异常显示，目前患者不能排除，需进一步观察及复查胸片和CT检查；②腹腔内脏伤：一般有腹痛及血压变化，需进一步腹部B超检查。处理：①完善入院常规检查；②予以抗炎、止血、补液等治疗，心电监护，注意血压等生命体征变化；③观察全身出血情况