脊柱全麻手术后并发症的护理预防与并发症处理及功能恢复
Postoperative Complication Prevention, Management and Functional Recovery in Spinal Surgery under General Anesthesia

脊柱全麻手术(Surgery under general spinal anesthesia)是治疗脊柱疾病的重要手段，但术后并发症严重影响患者康复及生活质量。本研究系统阐述了脊柱全麻手术后并发症的护理预防、处理及功能恢复策略，旨在为临床实践提供循证依据。术后并发症涉及神经系统(脊髓损伤、神经根损伤、术后谵妄)、呼吸系统(肺不张、呼吸抑制、呼吸道梗阻)、循环系统(低血压、心律失常)及其他系统(切口感染、深静脉血栓、压疮)，其发生与手术操作、麻醉管理及患者基础状况密切相关。通过多学科协作的围手术期护理干预，可有效降低并发症风险并改善预后。术前护理重点包括全面评估患者身心状态、开展个体化健康教育及规范术前准备。术中护理强调体位管理、生命体征监测及呼吸道维护，以减少神经血管损伤及呼吸循环并发症。术后护理聚焦病情观察、管道管理及阶梯式康复训练，早期识别并处理并发症。针对不同系统并发症，护理措施具有特异性：神经系统并发症需注重体位管理及神经功能康复；呼吸系统并发症需加强气道维护及呼吸支持；循环系统并发症需优化容量管理及心功能监测；其他并发症需落实感染防控、血栓预防及皮肤护理。本研究整合国内外最新研究进展，提出基于循证医学的规范化护理路径，并探讨智能化监测设备、多学科协作模式及延续性护理在脊柱手术护理中的应用前景，通过系统化的护理干预，可显著降低脊柱全麻手术后并发症发生率，促进患者功能恢复，提高整体医疗质量。
General spinal anesthesia surgery is an important approach for treating spinal disorders, but postoperative complications significantly impact patient recovery and quality of life. This systematic review examines nursing strategies for preventing and managing complications while promoting functional recovery after general spinal anesthesia surgery, aiming to provide evidence-based guidance for clinical practice. Postoperative complications involve multiple systems including neurological (spinal cord injury, nerve root damage, postoperative delirium), respiratory (atelectasis, respiratory depression, airway obstruction), circulatory (hypotension, arrhythmia), and other systems (surgical site infection, deep vein thrombosis, pressure ulcers). These complications are closely associated with surgical techniques, anesthesia management, and patients’ baseline conditions. Multidisciplinary perioperative nursing interventions can effectively reduce complication risks and improve outcomes. Preoperative nursing focuses on comprehensive patient assessment, individualized health education, and standardized preoperative preparation. Intraoperative nursing emphasizes proper positioning, vital signs monitoring, and airway maintenance to minimize neurovascular injuries and respiratory/circulatory complications. Postoperative nursing prioritizes condition monitoring, drainage tube management, and progressive rehabilitation training for early complication detection and management. System-specific nursing measures include: neurological complications require proper positioning and neurorehabilitation; respiratory complications demand airway maintenance and respiratory support; circulatory complications need optimized fluid management and cardiac monitoring; other complications require infection control, thrombosis prevention, and skin care. This