腰椎退变性疾病患者术后早期日常生活功能恢复及康复行为现状的队列研究

Investigation of the Short-Term Daily-Function Recovery and Rehabilitation Behaviors of Degenerative Lumbar Disease Patients Undergone Lumbar Spine Surgery:A Cohort Study

目的了解腰椎退变性疾病手术患者术后早期(一个月)的日常生活功能恢复及康复行为现状。方法采用前瞻性队列研究方法,术前采用问卷调查法收集患者基线资料,术后一个月进行电话随访,随访内容包括"症状评定"、"日常生活功能"、"康复行为评价"三方面。结果共计191例腰椎退变性疾病患者入组,术后一个月100%获得随访。(1)日常生活功能恢复情况:研究对象术后一个月时腰腿痛、JOA评分与术前比较,差异有统计学意义(P<0.01);术后自理能力、睡眠情况及日常功能总体得分与术前比较,差异有统计学意义(P<0.05),洗澡、弯腰、举或拿物得分低于术前(P<0.05);(2)康复行为情况:术后一个月内,82.7%的患者每日坚持进行踝泵练习;90.1%每日坚持进行直腿抬高练习;74.3%进行腰背肌功能锻炼,其中有72.8%进行五点支撑的练习,17.8%进行飞燕式练习,飞燕式练习的动作规范程度最差(非常规范者仅占38.2%)。结论术后一个月时,研究对象的临床症状有较大改善,日常生活功能尚存在不足,需要在伤口辨别、洗澡等方面加强院内及社区健康教育;研究对象的康复行为总体依从性较好,腰背肌锻炼的康复行为相对薄弱,各项动作的规范性需要进一步加强。

Objective To investigate the short-term recovery of the daily function and rehabilitation behaviors of patients undergone lumbar spine surgery. Methods A prospective cohort study was carried out.All patients who met the inclusion criteria were recruited from one same spinal surgery ward.The baseline data were collected before surgery,the follow-up data,which included ＂symptom analysis＂,＂daily function analysis＂ and ＂rehabilitation behaviors analysis＂ were collected one month after the surgery. Results A total of 191 patients were recruited in the study and followed-up postoperatively.Compared with before,One month after operation,the patients made a significant difference in daily functions generally（P0.05）,and as well as in ＂showering＂,＂bending＂ and ＂raising and taking things＂（P0.05） in comparison with before.one month after operation,82.7% patients were doing ＂ankle-pump＂,90.1% were doing ＂straight leg raising＂,74.3% were practicing waist back muscle exercise（of them 72.8% were doing five point supporting exercise and 17.8% were doing swallow exercise）. Conclusion Patients′ daily function recovery and rehabilitation behaviors are good generally;some of the daily functions and the waist back muscle practice are relatively weak and need further education.