创伤性脊髓损伤患者术后肢体功能康复训练方案的构建与应用

Limb Function Rehabilitation Training Program Construction and Application of Traumatic Spinal Cord Injury Patients with Perioperative

目的通过文献回顾和Delphi法以循证医学为基础构建标准化、创伤性脊髓损伤患者术后肢体功能康复训练方案。方法运用Delphi专家咨询法构建创伤性脊髓损伤患者术后肢体功能康复训练方案。2011年6-12月,选取上海市两所三级综合性医院骨脊柱科和骨创伤科住院的患者113例为研究对象,根据其住院单双号将其分为对照组和肢体功能康复训练方案组(简称方案组),比较两组患者肢体功能康复知识掌握程度和并发症的发生率。结果在肢体主动和被动锻炼的方法、疼痛的汇报和缓解方法、出院后各种并发症预防方法与重要性等方面,方案组患者掌握程度明显优于对照组,差异均有统计学意义(均P<0.05)。在关节活动范围(range of motion,ROM)缩小、便秘和腹胀等并发症的发生率上,方案组患者优于对照组,差异有统计学意义(P<0.05)。结论实施创伤性脊髓损伤患者术后肢体功能康复训练方案能提高脊髓损伤患者对肢体功能康复知识的认知水平,并且明显减少术后并发症的发生,促进了患者肢体功能的康复,提高了患者的生活质量。

Objective To build standardized and timeliness perioperative rehabilitation training program of limb function for traumatic spinal cord injury patients based on evidence--based medicine through literature review and the Delphi experts consultation methods. Methods Using Delphi experts consultation methods to structure perioperative rehabilitation training program of limb function for patients with traumatic spinal cord injury. Totally 113 patients from bone spine and bone trauma departments of 3 comprehensive hospitals were selected and divided into control group and limb function rehabilitation training group . Master degree and complication incidence were compared between the two groups. Results Body active passive exercise method, pain reporting and alleviate pain methods, prevention methods and knowledge significance of various complications after dis- charge in the training group is significantly better than those in the control group（P〈0.05）. Complications inci- dence of ROM reduce, abdominal distension and constipation in the training group were significantly less than those in the control group（P〈0. 05）. Conclusion Implementation of traumatic spinal cord injury patients perioperative limb function rehabilitation training scheme can improve the mastery degree of limb function rehabilitation related knowledge, obviously reduce the postoperative complications, and promote the patients＇ limb function recovery and quality of life.