Lumbar Discectomy腰椎間盤切除術(shù) A Patient’s Guide to Lumbar Discectomy腰椎間盤切除術(shù)患者指南 Complications 并發(fā)癥 What might go wrong? 手術(shù)可能會出現(xiàn)什么意外,？ As with all major surgical procedures, complications can occur. Some of the most common complications following lumbar discectomy include
與所有重要的外科手術(shù)一樣，腰椎間盤切除術(shù)也可能發(fā)生并發(fā)癥,，最常見的包括：
This is not intended to be a complete list of possible complications. 這里不打算把所有可能的并發(fā)癥都羅列出來,。 Problems with Anesthesia 麻醉的問題 Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. In addition, anesthesia can affect lung function because the lungs don’t expand as well while a person is under anesthesia. Be sure to discuss the risks and your concerns with your anesthesiologist. 當(dāng)在手術(shù)期間給予的麻醉與患者正在服用的其他藥物的發(fā)生反應(yīng)時可能出現(xiàn)問題。在極少數(shù)情況下,，麻醉本身會對患者帶來麻煩,。此外，麻醉會影響到肺功能,，因為當(dāng)人被麻醉時肺不能很好地擴張,。一定要與你的麻醉師討論所存在風(fēng)險和你所關(guān)注的問題。 Thrombophlebitis (Blood Clots) 血栓性靜脈炎 View animation of pulmonary embolism （原文動畫無法下載,，從網(wǎng)上找了幾個相關(guān)視頻） Thrombophlebitis, sometimes called deep venous thrombosis (DVT), can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. (Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system.) Most surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible. Two other commonly used preventative measures include 血栓性靜脈炎，有時稱為深靜脈血栓形成（DVT）,，可在任何手術(shù)后發(fā)生,。當(dāng)腿的大靜脈中的血液形成血凝塊時它就會發(fā)生。這可能會導(dǎo)致下肢腫脹,，摸上去皮溫有升高,，并有疼痛，如果在靜脈中的血栓掉下來,，它們可以游行至肺,，停留在毛細(xì)血管中并會切斷肺的一部分血供。這就叫做肺栓塞。栓塞指的是某些物品的碎片通過血管系統(tǒng)轉(zhuǎn)運,。大多數(shù)外科醫(yī)生非常重視預(yù)防深靜脈血栓,，有很多方法可以減少深靜脈血栓的風(fēng)險，但最有效的方法是盡快進行活動,。另外有兩種最常用的措施包括： · pressure stockings to keep the blood in the legs moving · medications that thin the blood and prevent blood clots from forming · 使用彈力襪保持下肢血液的流動 · 使用能降低血液稠度和阻止血栓形成的藥物
Infection 感染 Infection following spine surgery is rare but can be a very serious complication. Some infections may show up early, even before you leave the hospital. Infections on the skin’s surface usually go away with antibiotics. Deeper infections that spread into the bones and soft tissues of the spine are harder to treat. They may require additional surgery to treat the infected portion of the spine. 脊柱術(shù)后出現(xiàn)感染很罕見,，但這卻是一個非常嚴(yán)重的并發(fā)癥。有些感染可能較早出現(xiàn),，甚至在你出院之前就已經(jīng)出現(xiàn)了,。皮膚表面出現(xiàn)的感染通常在使用抗生素后會消失，但蔓延到脊柱骨和軟組織的深部感染很難治療,，可能需要另外的手術(shù)來治療脊柱受感染的部位,。 Nerve Damage 神經(jīng)損傷 在椎管附近的任何手術(shù)都有可能引起脊髓和脊神經(jīng)的損傷。當(dāng)手術(shù)器械碰撞或切割到神經(jīng)組織時會出現(xiàn)損傷,，神經(jīng)損傷也可以出現(xiàn)在神經(jīng)周圍的腫脹或疤痕組織的形成時,。神經(jīng)損傷可導(dǎo)致神經(jīng)支配區(qū)域肌肉無力和感覺缺失。 Ongoing Pain 疼痛 Discectomy is especially helpful for patients whose main complaint before surgery is leg pain. When back pain has been the main complaint, however, surgical results vary. If the pain continues after surgery or becomes unbearable, talk to your surgeon about treatments that can help control your pain. 椎間盤切除術(shù)對于手術(shù)前主要癥狀是腿痛的患者特別有用,。然而，當(dāng)主要癥狀是腰痛時,，手術(shù)效果就不一樣,。如果手術(shù)后疼痛繼續(xù)或變得無法忍受，與你的外科醫(yī)生談?wù)勚委煼椒?，有助于控制你的疼痛?/span> After Surgery 術(shù)后
What happens after surgery? 術(shù)后會發(fā)生什么,？ Patients are usually able to get out of bed within a few hours after surgery. However, you will be instructed to move your back only carefully and comfortably. The drain tube is normally taken out the day after surgery. Patients are able to return home when their medical condition is stable. 患者通常能夠在手術(shù)后數(shù)小時內(nèi)下床。然而你會被指導(dǎo),，只能小心和舒適地移動你的背部,。引流管通常在手術(shù)后的第二天拔出?；颊咴诓∏榉€(wěn)定時能夠回家,。 Most patients leave the hospital the day after surgery. They are usually safe to drive within a week or two. Bending and lifting should be avoided for four to six weeks. People generally get back to light work in two to four weeks and can do heavier work and sports within two to three months. Workers whose jobs involve strenuous manual labor may be counseled to consider a less strenuous job. 大多數(shù)患者在手術(shù)后的第二天離開醫(yī)院。 他們通?？梢栽谝粌蓚€星期內(nèi)開車,。患者應(yīng)避免彎腰和負(fù)重四到六周,。人們通常在兩到四個星期內(nèi)恢復(fù)輕松工作,，并且可以在兩三個月內(nèi)做更重的工作和運動。那些涉及到繁重的體力勞動的工人可以建議考慮一個不費力的工作,。 Patients usually begin outpatient physical therapy two to three weeks after the date of surgery. 患者通常在手術(shù)后2~3周開始門診物理治療,。 Rehabilitation 恢復(fù) What should I expect as I recover? 當(dāng)我恢復(fù)時會怎樣？ Many surgeons prescribe outpatient physical therapy within three weeks after surgery. Physical therapy after lumbar discectomy is generally only needed for six to eight weeks. You should expect full recovery to take up to four months. 許多外科醫(yī)生建議患者在手術(shù)后3周內(nèi)門診物理治療。腰椎間盤切除術(shù)后的物理治療通常只需要6~8周,。 預(yù)期完全恢復(fù)需要4個月,。 At first, therapy focuses on controlling pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals. Your therapist may also use massage and other hands-on techniques to ease muscle spasm and pain. 首先，治療的重點是控制疼痛和炎癥,。冰敷和電刺激治療通常用于幫助實現(xiàn)這些目標(biāo),。您的治療師還可以使用按摩和其他動手技術(shù)來緩解肌肉痙攣和疼痛。 Active treatments are added slowly. These include exercises for improving heart and lung function. Walking and swimming are ideal cardiovascular exercises after this type of surgery. Therapists also teach specific exercises to help tone and control the muscles that stabilize the low back. 慢慢增加主動運動治療,。這些包括用于改善心臟和肺功能的鍛煉,。步行和游泳是這類手術(shù)后理想的心血管鍛煉。 治療師還教授特定的練習(xí),，以幫助協(xié)調(diào)和控制穩(wěn)定腰部肌肉,。 Your therapist works with you on how to move and do activities. This form of treatment, called body mechanics, helps you develop new movement habits. This training helps you keep your back in safe positions as you go about your work and daily activities. At first, this may be as simple as learning how to move safely and easily in and out of bed, how to get dressed and undressed, and how to do some of your routine activities. Then you learn how to keep your back safe while you lift and carry items and as you begin to do more strenuous activities. 治療師與您一起設(shè)法活動和運動。這種治療形式,，被稱為人體力學(xué),，用于幫助您養(yǎng)成新的活動習(xí)慣。當(dāng)您開始工作和日?；顒訒r,，這種訓(xùn)練幫助您保持你的腰背部處于安全的位置。起初,，這可能很簡單,，如學(xué)習(xí)如何安全方便地上下床，如何穿衣服和脫衣服,，以及如何做一些你的日?；顒印Ｈ缓?，當(dāng)你抬起和攜帶物品時,，當(dāng)你開始做更多的重體力工作時，你要學(xué)習(xí)如何保持你的背部安全,。 As your condition improves, your therapist tailors your program to help prepare you to go back to work. Some patients are not able to go back to a previous job that requires strenuous tasks. However, your therapist may suggest changes in job tasks that enable you to go back to your previous job. Your therapist may also suggest alternate forms of work. You’ll learn to do your tasks in ways that keep your back safe and free of extra strain. 隨著病情的改善,，治療師將開始調(diào)整計劃，以幫助您作好回去工作的準(zhǔn)備,。一些患者無法回到以前那種需要繁重和艱巨任務(wù)的工作,。治療師可能建議改變工作任務(wù)，以恢復(fù)以前的工作,。治療師還可以提供其他建議來改變干活的方式,。從中您將學(xué)到干活的正確方式，以保持腰的安全,，避免額外的用力,。 Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems. 在您的治療結(jié)束之前,，治療師將教會您一些方法，以避免將來可能發(fā)生的問題,。
（姜嘉偉 翻譯 保國鋒 校對）
姜嘉偉,，南通大學(xué)2016屆骨科碩士研究生，目前在南通大學(xué)第二附屬醫(yī)院參加規(guī)范化培訓(xùn),。
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