腰椎间盘突出症术后早期功能锻炼与并发症的相关性研究

POST-OPERATIVE EARLY FUNCTIONAL EXERCISES IN LUMBAR INTERVERTEBRAL DISK HERNIA AND THEIR RELATIONSHIP TO COMPLICATIONS: A Correlativity Study

为探讨腰椎间盘突出症术后早期功能锻炼的临床价值及其与并发症发生相关性。选择腰椎间盘突出症髓核摘除手术治疗病人100例,随机分为早期功能锻炼组和对照组各50例。早期功能锻炼组从麻醉消失开始进行下肢的自由伸、屈,活动足趾,直腿抬高活动,到逐渐进行腰背肌的二点式、三点式、五点式、飞燕点水式锻炼至完全康复期。对照组按常规方法进行。经过0.5、1、2、12个月的观察和随访,对比两组的功能康复和并发症发生情况。结果显示,两组的并发症发生情况无明显差异,而症状和体征缓解率及疗效的优良率早期功能锻炼组优于对照组,两组有显著差异(P<0.05)。表明腰椎间盘突出症术后早期指导病人功能锻炼具有可行性,在不增加并发症危险的同时,可提高康复效果。

In order to study the clinical value of post-operative early functional exercises(POEFE) in lumbar intervertebral disk hernia(LIDH) and their relationship to the complication occurrence,100 cases of LIDH treated by nucleus-pulposus removal were selected and randomly divided into the POEFE and the control groups(n=50 cases each);the POEFE group was encouraged to do POEFE from anesthesia disappearance till complete recovery,which included free extension and flexion of the lower extremities,exercises of the toes and straight-leg raising at the beginning and then lumbodorsal-muscle exercises,such as the two-point,three-point,four-point,five-point and flying-swallow-nodding;while the control group was treated by the conventional methods;the functional recovery and complication occurrence of the two groups were compared through the follow-ups and observations of 0.5,1,2,6 and 12 months.The results showed an advantage of the POEFE group over the control in the remission rate of the symptoms and signs and in the excellent-good rate of the therapeutic effect with a significant difference(P < 0.05) but no significant difference of the two groups in complication occurrence,suggesting that POEFE in LIDH has feasibility and could improve the recovery result but not increase the danger of complication occurrence in LIDH.