Perioperative nursing care of patients with tethered cord syndrome
脊髓栓系综合征患者围手术期的护理

摘要

脊髓栓系综合征是由于各种先天和后天的原因引起脊髓或圆锥受牵拉，导致脊髓末端位置过低，脊髓发生缺血、缺氧、神经组织变性而引起一系列神经功能障碍和畸形的综合征。脊髓栓系综合征属于一种先天性的出生缺陷性疾病，它随着孩子年龄的增长，身高的增长而慢性的、进行性的加重。脊髓栓系综合征主要的临床表现，首先是疼痛，这类患儿可能会出现腰腿的疼痛的表现。第二个是感觉的障碍，主要是麻木的一些表现。还有一个是骨骼肌和运动的畸形，主要表现是肌肉的萎缩和脚的变形，如出现马蹄足和内翻足。还有一类表现是大小便的功能障碍，患儿常常表现为便秘、尿费力、尿潴留，少数的患儿可能出现大小便控制不住，或者大小便失禁的情况。当然，脊髓栓系临床表现还有一类就是腰骶部特征性的皮肤的表现，患儿可以表现为皮毛窦、腰骶皮肤的毛发的增多，还有腰骶部的血管瘤是最为常见的。该疾病越早治疗效果越好，临床中通常通过手术治疗，清除骨赘、纤维间隔、硬脊膜袖和松解纤维神经血管束及其粘连，解除对脊髓的拴系。但是该手术较复杂，且术后的并发症发病率较高，因此在围手术期间需要进行有效的护理，达到降低手术难度和降低并发症的目的。本文旨在对脊髓栓系综合征的围手术期间的护理进行阐述，以此为脊髓栓系综合征的治疗和护理提供参考。

Abstract

Tethered cord syndrome (TCS) is a syndrome that results in a series of neurological dysfunction and deformities due to various congenital and postnatal reasons, such as traction of the spinal cord or conus, low position of the end of the spinal cord, ischemia, hypoxia and degeneration of nerve tissue in the spinal cord. The sooner the disease is treated, the better. In clinical practice, surgery is usually used to remove osteophytes, fibrous septum, dural sleeves, release fibrous neurovascular bundles and their adhesions, and remove the tethering of the spinal cord. However, the operation is complex and the incidence rate of postoperative complications is high. Therefore, effective nursing is required during the perioperative period to reduce the difficulty of operation and complications. The purpose of this article is to elaborate the perioperative nursing of tethered cord syndrome, so as to provide reference for the treatment and nursing of tethered cord syndrome.