预见性护理干预对布鲁杆菌病性脊椎炎术后VAS及Oswestry功能障碍指数相关影响的临床评价

Evaluation of nursing intervention on VAS pain score and Oswestry disability index in postoperative brucellosis spondylitis patients

目的探讨预见性护理干预对布鲁杆菌病性脊椎炎患者术后视觉模拟量表(Visual Analogue Scale,VAS)及Oswestry功能障碍指数的影响,以便提高术后临床疗效。方法将39例一期病灶清除术联合后路椎弓根内固定手术治疗患者随机分2组,常规性治疗组19例和预见性护理组20例,常规护理组进行常规护理,预见性护理组实施超前镇痛护理计划及健康教育临床路径。对2组术前和术后不同时点VAS和Oswestry功能障碍指数评分,以及术后1、3、6个月的临床疗效进行评价,并随访2组1、3、6个月的用药依从性。结果 2组术前具有可比性,随着时间推移,通过VAS评分、用药依从性及Oswestry功能障碍指数评分比较,同一时间点预见性护理组与常规护理组差异有统计学意义(P<0.05);临床疗效评价显示,预见性护理组优良率明显高于常规护理组,且同一时间点预见性护理组与常规护理组差异有统计学意义(P<0.05)。结论实施预见性护理干预可以改善布鲁杆菌病性脊椎炎患者术后VAS评分及Oswestry功能障碍指数,对术后日常活动的康复和提高临床疗效有显著效果。

Objective To evaluate the nursing care on Visual Analogue Scale（VAS）pain score and Oswestry disability index of postoperative brucellosis spondylitis patients and to improve clinical outcome. Methods Thirty-nine cases who underwent a debridement and posterior pedicle screw fixation surgery were divided into two groups.One group is routine nursing group（group A,19cases）which were used as control group,the other group is nursing care intervention group（group B,20cases）in which a preemptive analgesia care plans,nursing education,medication compliance and health education clinical pathway were carried out.We compared the postoperative VAS score and Oswestry Disability Index between the two groups.All the cases were followed up at 1,3and 6month after the operation.Results The two groups were comparable before operation.There was a significant difference between the group B and the group A in the VAS score,the medication compliance and the Oswestry Disability Index at the same time point after the surgery（P〈0.05）.Cases in group B were significantly better than ingroup A,especially in the early time after the operation（P〈0.05）.Conclusion Implementation of the nursing care interventions can improve VAS scores and Oswestry Disability Index in brucellosis spondylitis patients,and it has significant effect on the rehabilitation and improvement of clinical curative effect after operation.