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1、Lumbar disc herniation in nursing roundsPatient data：Patients with Zheng Baorong, female, 54 years old, a chief complaint of low back pain 8 years, increase with double lower limbs pain numbness and weakness in 2 monthsThe patient is now history：The patient said in 8 years ago five apparent induceme
2、nt appear gradually lower back pain, lower limb swelling and discomfort, fatigue after the increase of rest after remission, and occasional pain, line of symptomatic treatment, symptoms can be relieved, then still recurring symptoms. 2 months ago the exacerbation of symptoms and gradually appeared i
3、n both the lateral lower leg and foot pain, posterolateral, lower extremity weakness, pain like stabbing, burning, was continuing, especially with the double foot is heavy, night is obvious, the intense pain affect sleep, oral pain because of poor efficacy, and double the dorsum of the foot, foot nu
4、mbness, consciously plantar on the cotton . The patients for further treatment to the hospital, outpatient investigation to lumbar disc herniation for the diagnosis of wards. In the course of the disease in patients without obvious fever, night sweats, fatigue symptoms, right foot fracture after lon
5、g time bed double lower limb muscle atrophy, and decreased body weight of about 10kg, poor sleep, diet, two times can be.Characteristics of disease：Lumbar disc herniation is refers to the degeneration of intervertebral disc, fibrous ring rupture, the nuclear organization salient stimuli and compress
6、ion of the nerve root and cause a syndrome. Traditional Chinese medicine books without lumbar intervertebral disc protrusion in the name of. Lumbar disc corresponds to an amphiarthrosis, is covered by hyaline cartilage plates, annulus fibrosus and nucleus pulposus composition, distribution in the lu
7、mbar spine bone room. Lumbar intervertebral disc degenerative changes or trauma induced by fibrous ring rupture, nucleus pulposus prolapse from rupture, compression lumbar nerve, and leg radioactivity pain, so the medical profession that lumbar disc herniation is a low back and leg pain, rheumatism
8、category. Heres Bian Tingting to introduce the symptoms of lumbar, lumbar disc herniation patients the most common symptoms are pain, low back pain, sciatica performance, typical sciatica is at the back of the thigh, hip, leg lateral to the heel or foot back pain radiation. According to clinical sta
9、tistics, about 95% of the lumbar disc herniation patients have varying degrees of pain, 80% patients with lower extremity pain. Especially low back pain, lumbar disc herniation not only is the most common symptom, is also one of the earliest symptoms. The pain occurs mainly due to the prominent, deg
10、eneration of nucleus pulposus on adjacent tissues ( mainly for sinus vertebral nerve and spinal nerve root stimulation and oppression, and at the same time ) in the nucleus pulposus in glycoprotein and other biological material overflows, the release of histamine and other local chemical inflammatio
11、n, induced by chemical and mechanical nerve root caused by inflammation, cause or light or heavy chronic pain of waist and leg. And the lumbar degeneration also often occurring simultaneously in the waist of the other organizations, such as the lumbar facet joints, ligaments, muscles of waist, causi
12、ng the local tissue of chronic inflammation, cause pain. Two factor interaction, mutual aggravation, the back and leg pain for sexual development. Protrusion of the lumbar intervertebral disc herniated nucleus pulposus in front of posterior longitudinal ligament called outstanding , through the post
13、erior longitudinal ligament into the spinal canal, known as the prolapse . According to the nucleus pulposus rearward protrusion part is divided into 3 type:1 after the outer lateral protrusion: fibrous ring of the weakest part of the rear in the intervertebral disc in the midline, this itself is we
14、ak, and lack of the posterior longitudinal ligament of the powerful central fiber support, therefore, is the waist intervertebral disc prominent the most common site of. Clinically most common, accounting for about 80%.2 central protrusion: refers to the nucleus pulposus through the annulus posterio
15、r central projection, reach the posterior longitudinal ligament under. In addition to cause sciatic nerve symptoms, but also can stimulate or compression of the cauda equina, manifested as perineal paralysis and the size of obstacles.3 prominent within the intervertebral foramen and far lateral: ref
16、ers to the nucleus pulposus through the rear of the fiber ring back and posterior longitudinal ligament into the spinal canal, into the intervertebral foramen, easily missed, but fortunately, its incidence is low, only about 1%. The following from Wu Junhua to tell you about the etiology.Nursing dia
17、gnosis and measure ofPain from a herniated nucleus pulposus pressure edema of nerve root compression and spasm.( 1) the rest: patients in the acute phase of absolute horizontal rigid bed rest, three weeks after illness allows ambulation.( 2): the patient supine posture, head elevation of 30 degrees,
18、 knees, the popliteal fossa on a soft pillow.( 3) and pelvic traction( 4): according to the prescribed application drug analgesia analgesics or non-steroidal drugs.( 5 ): psychological nursing can relieve distractions such as listen to music and chat.Constipation with cauda equina compression and pr
19、olonged bed rest on( 1) bowel training: training the patient bed defecation, guide patients to use the potty.( 2) diet and drinking water: to give the patient is rich in fiber digestible diet, encourage patientsMore water to reduce fecal dry.( 3) drugs: severe constipation, according to medicineWill
20、 give enema or laxatives.( 4) to create a suitable environment: defecation as mentionedFor the secret of environment and enough time to wait.Somatic dyskinesia and intervertebral disc herniation, traction and operation about( 1) relieve muscle spasm: for pain caused by restricted activities give the
21、 pain measures, while the local hot compress to relieve muscle spasm.( 2) position: pelvic traction supine position, postoperative patients for pillow lying on a hard bed, turning over once every 2 hours.( 3) low back muscle exercise1) five point support method2) three point support method3) four po
22、int support method.4) head of upper limbs and the back back5) lower limbs and waist back6) the whole body backwardThe potential complications of cerebrospinal fluid leakage, urinary retention or infection( 1) for monitoring vital signs: in addition to detection of basic life signs observed sensory a
23、nd motor.( 2) position: according to the condition and operation of different types of anthropometric, generally slightly raised bed.( 3) strengthen the incision and drainage nursing: Observation of incision and drainage tube is smooth, colour and quantity of liquid, such as abnormal timely report to a doctor.( 4): urinary tract nursing recording intake and output volume, assist the urination and so.( 5 ): strengthening the prevention of infectionVital signs monitoring; cutThe observation and nursing.
