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椎間孔鏡器械主鏡器械產(chǎn)品說明:
portant; word-wrap: break-word !important;">術(shù)后并發(fā)癥:
portant; word-wrap: break-word !important;">? 神經(jīng)損傷、感染、突出物摘除殘留、髓核再突出、椎管內(nèi)血腫、腰大肌血腫、終板炎等
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">臨床表現(xiàn):感覺遲鈍或者痛覺過敏,下肢肌力下降,反射減弱。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">可能發(fā)生的原因:
portant; word-wrap: break-word !important;">1、穿刺損傷
portant; word-wrap: break-word !important;">2、擴(kuò)孔過程中的損傷或者擠壓
portant; word-wrap: break-word !important;">3、鏡下摘除髓核時(shí)損傷神經(jīng)或者電凝損傷
portant; word-wrap: break-word !important;">4、術(shù)后血腫壓迫神經(jīng)
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">預(yù)防:對(duì)于手術(shù)的神經(jīng)損傷是我們手術(shù)中最需要預(yù)防的,也是我們最擔(dān)心的并發(fā)癥。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">預(yù)防:手術(shù)很多過程及器械的設(shè)計(jì)都是為了避免損傷神經(jīng)。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">預(yù)防:1、恰當(dāng)?shù)穆樽?,局麻,注意有些部位注入麻醉藥?huì)使反應(yīng)遲鈍。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">預(yù)防:
portant; word-wrap: break-word !important;">2、標(biāo)準(zhǔn)的穿刺位置
portant; word-wrap: break-word !important;">3、術(shù)中操作的輕巧和解剖結(jié)構(gòu)的清晰,這個(gè)比較復(fù)雜,也是很多老師講課的主要內(nèi)容。
portant; word-wrap: break-word !important;">4、良好的止血
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">處理:
portant; word-wrap: break-word !important;">1、對(duì)于出現(xiàn)痛覺過敏、燒灼樣疼痛的患者,口服加巴噴丁、普瑞巴林等,可以做選擇性神經(jīng)根阻滯。一般一周至一月內(nèi)可以恢復(fù)。
portant; word-wrap: break-word !important;">? ? ?該痛覺過敏是一種神經(jīng)病理性疼痛,曲馬多、嗎啡等止痛效果不佳。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">處理:
portant; word-wrap: break-word !important;">2、對(duì)感覺遲鈍、麻木、肌力下降的病例,營養(yǎng)神經(jīng)、康復(fù)治療為主。假如術(shù)后即刻確定有神經(jīng)損傷,建議給予甲強(qiáng)龍沖擊治療,能減輕很多神經(jīng)損傷。
portant; word-wrap: break-word !important;">神經(jīng)損傷:
portant; word-wrap: break-word !important;">處理:
portant; word-wrap: break-word !important;">3、神經(jīng)損傷早期,局部給予激素,也能減輕神經(jīng)損傷。
portant; word-wrap: break-word !important;">感染:
portant; word-wrap: break-word !important;">預(yù)防:1、操作者和環(huán)境因素
portant; word-wrap: break-word !important;">? ? ? ?無菌環(huán)境、器械滅菌、無菌操作、術(shù)前半小時(shí)常規(guī)預(yù)防性抗菌素、沖洗液加入慶大或者臭氧等
portant; word-wrap: break-word !important;">感染:
portant; word-wrap: break-word !important;">預(yù)防:2、患者因素
portant; word-wrap: break-word !important;">? ? ? 患者免疫力低下、糖尿病、長時(shí)間臥床、局部感染灶等
portant; word-wrap: break-word !important;">感染:
portant; word-wrap: break-word !important;">臨床表現(xiàn):
portant; word-wrap: break-word !important;">? ? ? ?術(shù)后幾天或者數(shù)月出現(xiàn)腰背部或者腹部的劇烈 疼痛,活動(dòng)后加重,均需要考慮到可能發(fā)生感染。
portant; word-wrap: break-word !important;">感染:
portant; word-wrap: break-word !important;">臨床表現(xiàn):
portant; word-wrap: break-word !important;">? ? ? ?一般無下肢放射痛,全省發(fā)熱癥狀不明顯。不能依據(jù)白細(xì)胞升高和分類變化診斷。
portant; word-wrap: break-word !important;">感染:
portant; word-wrap: break-word !important;">臨床表現(xiàn):
portant; word-wrap: break-word !important;">? ? ?一般有血沉、C反應(yīng)蛋白、降鈣素原的持續(xù)升高。
portant; word-wrap: break-word !important;">? ? ?MRI可以做出診斷。
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