Nursing Observation of Neuroelectrophysiological Monitoring in Three dimensional Orthopedic Operation of Scoliosis
神经电生理监测在脊柱侧弯三维矫形手术中的护理观察

摘要

目的 分析神经电生理监测在脊柱侧弯三维矫形手术中的护理方法，旨意为相关人员的研究工作提供参考文献。方法 本实验择取2019.6.8~2021.6.8本院收治的拟接受脊柱侧弯三维矫形治疗疾病的先天性/特发性脊柱侧弯患者100例为研究样本。患者在接受手术治疗疾病过程中，护士为其开展针对性围术期护理，分析结果。结果 患者手术用时均值为（7.19±2.58）h。术中共计2例出现II级压力性创伤，2例出现电灼伤。经处理后，患者痊愈。8例病患出现神经监测预警。7例病患在矫正中，两侧下肢SEP降低幅度达到了50.00%~70.00% ，护士提醒后暂停守护及时变更手术方案。等到其SEP恢复后继续手术，在此后神经功能复原到原有水平。1例病患的SEP波幅降低幅度达到了70.00%~90.00%，潜伏期延长达到50.00%。患者的MEP波形完全消失。应用紧急性处理以后，患者没有显著好转。病患在手术以后2h，开展紧急手术探查，选择内固定钉棒松解处理，对患者实施间断性高压氧疗法，同时对病患开展营养神经对症干预。术后半年病患下肢有一定恢复，但是下肢肌力水平没有发现显著改变。结论 在对患者开展脊柱侧弯三维矫形手术过程中，应用多模式电生理监测技术，能降低患者术中并发症发生率。在此同时，于围术期内对患者开展针对性护理，能取得满意成效。这一方案值得进一步在临床内推广以及应用。

Abstract

Objective: To analyze the nursing methods of neuroelectrophysiological monitoring in scoliosis three-dimensional orthopedic surgery, and to provide references for the research work of related personnel.
Methods In this study, 100 patients with congenital/idiopathic scoliosis who were admitted to our hospital from August 2019 to August 2021.6.8 were selected as study samples. In the process of receiving surgery to treat the disease, the nurses carried out targeted perioperative nursing for the patients and analyzed the results.
Results The mean operation time was (7.19 ± 2.58) h. There were 2 cases of Grade II pressure trauma and 2 cases of electric burn during operation. After treatment, the patient recovered. Neuromonitoring and early warning occurred in 8 patients. During the correction of 7 patients, SEP of both lower extremities decreased by 50.00%~70.00%. After being reminded by the nurse, the nurse stopped guarding and changed the operation plan in time. Continue the operation after SEP recovery, and then the nerve function will recover to the original level. One patient's SEP amplitude decreased by 70.00%~90.00%, and the incubation period extended by 50.00%. The patient's MEP waveform disappeared completely. After emergency treatment, the patient did not improve significantly. 2 hours after the operation, the patient should carry out emergency surgical exploration, choose the internal fixation screw rod loosening treatment, implement intermittent hyperbaric oxygen therapy for the patient, and carry out symptomatic nutritional intervention for the patient. Half a year after the operation, the patient's lower limbs recovered to some extent, but there was no significant change in the level of lower limb muscle strength.
Conclusion   The application of multimodal electrophysiological monitoring technology in scoliosis surgery can reduce the incidence of intraoperative complications. At the same time, targeted nursing for patients during the perioperative period can achieve satisfactory results. This scheme is worthy of further promotion and application in clinical practice.