摘要
目的结合Meta分析探讨脊柱术后发生症状性硬膜外血肿(symptomaticspinalepidural hematoma,SSEH)的危险因素及观察要点,为脊柱术后发生SSEH的观察要点提供依据。方法计算机检索万方数据库和知网医学期刊,搜集关于脊柱术后患者SSEH的观察要点。数据库检索时限:建库至2023年3月。评价纳入研究的偏倚风险,采用RevMan 5.3软件进行Meta分析。将2021年1月—2023年3月本院收治的1864例脊柱手术患者中6例术后发生SSEH患者的护理进行回顾性分析,结合Meta分析总结发生SSEH早期征象的观察要点。结果6例术后发生SSEH的患者中2例患者合并脑梗疾病史,2例术后血压较高。Meta分析共纳入11项研究,9篇文献质量评分均≥6分,2篇文献质量评分为5分。结果显示,年龄>65岁、术前血小板计数、合并脑梗、合并高血压、凝血障碍、手术时间>2h及多节段手术是脊柱术后SSEH的观察要点。结论术前患者身体状况及疾病史等情况、术中患者手术情况、术后患者生命体征、双下肢神经功能、引流液变化、手术切口内疼痛等情况是脊柱术后症状性硬膜外血肿的观察要点。
Objective To explore risk factors and observation points of symptomatic epidural hemorrhage(SSEH)after spinal surgery combined with meta-analysis,and provide basis for observation points of SSEH after spinal surgery.Methods The paper retrieved Wanfang database and medical journals on CNKI with computer to collect observation points on SSEH of patients after spinal surgery.Database retrieval deadline:from database establishment to March 2023,risk of bias included in study was evaluated based on meta-analysis with RevMan 5.3 software.The paper reviewed and analyzed nursing of 6 out of 1864 spinal surgery patients with SSEH after surgery in our hospital from January 2021 to March 2023,and summarized observation points of early signs of SSEH combined with meta-analysis.Results 2 cases had cerebral infarction history ong 6 cases with SSEH after surgery,2 cases had higher postoperative blood pressure.11 studies were included in meta-analysis,quality scores of 9 literature were≥6,and quality scores of 2 literature were 5.Results showed,observation points included age>65,preoperative platelet count,concomitant cerebral infarction,concomitant hypertension,coagulation disorders,surgical time>2 hours,and multi segment surgery for SSEH after spinal surgery.Conclusion Observation points of symptomatic epidural hematoma after spinal surgery include preoperative physical condition,disease history,intraoperative surgical condition,postoperative vital signs,lower limb nerve function,drainage fluid changes,and surgical incision pain.
作者
樊莉
公维金
刘永涛
代群莉
祝明秋
FAN Li;GONG Weijin;LIU Yongtao;DAI QunLI;ZHU Mingqiu(Spinal Surgery Department,Xuzhou Medical University Affiliated Hospital,Xuzhou,Jiangsu 221000;Operating Room,Xuzhou City the First People's Hospital,Xuzhou,Jiangsu 221000)
出处
《智慧健康》
2024年第1期182-185,共4页
Smart Healthcare
