【摘要】 目的探讨"髌骨悬空位"在脊柱俯卧位手术中预防膝关节发生压疮的应用效果。方法选取2018年1月至2018年6月腰椎后路手术患者100例为传统组;选取2018年6月至2018年12月腰椎后路手术100例患者为改进组。在脊柱俯卧位手术中,传统组在膝关节表面黏贴泡沫敷料,并在膝关节下方放置软垫预防压疮;改进组在齐髌骨髌底上缘股骨远端处放置约4 cm厚度的软垫,使髌骨悬空不受压,观察并比较2组患者发生压疮并发症的情况。结果 2组压迫时间、压疮发生率比较,差异无统计学意义(P>0.05)。改进组压红发生率、压红面积、压红恢复时间均低于传统组,差异有统计学意义(P<0.05)。2组术后JOA评分均高于术前,术后ODI评分低于术前,差异均有统计学意义(P<0.05)。2组间术前JOA、ODI评分,术后JOA、ODI评分比较,差异无统计学意义(P>0.05)。结论脊柱内固定手术摆放俯卧位体位时,膝关节采用"髌骨悬空位",可以有效防止膝关节压红及压疮的发生,具有临床推广价值。更多还原

【Abstract】 Objective To investigate the application effects of "patella suspension position" in preventing pressure sore of knee joint during spinal prone position operation.Methods One hundred patients who underwent lumbar posterior surgery in our hospital from January 2018 to June 2018 were enrolled as traditional surgery group,however,the other 100 patients who underwent lumbar posterior surgery in our hospital from June 2018 to December 2018 were enrolled as the improved surgery group.The patients in traditional surgery group were treated by pasting foamdressing on the surface of knee joint,and placing soft pad under the knee joint to prevent pressure sore,however,the patients in improved surgery group were treated by placing a 4 cm thick cushion below patella bottom in order to free patella from compression.The complications of pressure sore were observed and compared between the two groups.Results There were no significant differences in pressure duration and the incidence of pressure sore between the two groups(P>0.05).The incidence of pressure red,pressure red area,recovery time of pressure red in improved surgery group were significantly lower than those traditional surgery group(P<0.05).Before and after the surgery,there were no significant differences in JOA scores and ODI scores between the two groups(P>0.05).After surgery the JOA scores in both groups were significantly higher than those before surgery,however, the ODI scores in both groups were significantly lower than those before surgery(P<0.05).Conclusion The spinal column internal fixation surgery at "patella suspension position" can effectively prevent the incidence of pressure sore of knee joint,thus,which has clinical promotion value.更多还原