The application of high-quality nursing in internal fixation surgery for spinal fractures complicated with spinal cord injury
优质护理在脊柱骨折合并脊髓损伤内固定术的应用

摘要

目的 评估优质护理在胸腰段脊柱骨折合并脊髓损伤后路椎弓根螺钉内固定术围手术期中的临床效果。方法 采用前瞻性随机对照试验，纳入2023年1月-2025年1月本院脊柱外科住院的80例胸腰段脊柱骨折合并脊髓损伤患者，随机数字表法分为对照组和实验组，各40例。对照组实施科室常规护理；实验组在此基础上实施“多学科—风险分级—持续康复”闭环优质护理。比较两组住院时间、术后30d并发症发生率及护理满意度。结果 实验组住院时间（8.33 ± 5.41d） 显著短于对照组（12.12 ± 3.83d）（P<0.001）。实验组术后并发症发生率5.00 %（2/40）低于对照组20.00 %（8/40）（P=0.043）。实验组护理满意度97.50 %（39/40）高于对照组77.50 %（31/40）（P=0.011）。结论 优质护理能够显著缩短住院时间，降低围术期并发症并提高护理满意度，对胸腰段脊柱骨折合并脊髓损伤患者的术后康复具有积极意义，值得在脊柱外科临床推广应用。

Abstract

Objective To evaluate the clinical efficacy of high-quality nursing care in the perioperative period of posterior pedicle screw fixation for thoracolumbar spinal fractures with spinal cord injury.
Methods A prospective randomized controlled trial was conducted, enrolling 80 patients with thoracolumbar spinal fractures and spinal cord injury admitted to the hospital's spine surgery department from January 2023 to January 2025. The patients were randomly divided into a control group and an experimental group, with 40 cases in each group. The control group received routine departmental nursing care, while the experimental group received closed-loop high-quality nursing care based on a "multidisciplinary-risk stratification-continuous rehabilitation" model in addition to the routine care. The length of hospital stay, incidence of complications within 30 days postoperatively, and nursing satisfaction were compared between the two groups.
Results The hospital stay in the experimental group (8.33 ± 5.41 days) was significantly shorter than that in the control group (12.12 ± 3.83 days) (P < 0.001). The incidence of postoperative complications in the experimental group was 5.00% (2/40), lower than the 20.00% (8/40) in the control group (P = 0.043). Nursing satisfaction in the experimental group was 97.50% (39/40), higher than the 77.50% (31/40) in the control group (P = 0.011).
Conclusion   High-quality nursing care can significantly reduce hospital stay, decrease perioperative complications, and improve nursing satisfaction, demonstrating positive significance for postoperative rehabilitation in patients with thoracolumbar spinal fractures and spinal cord injury. It is worthy of clinical promotion and application in spine surgery.