一体化康复模式对腰椎退行性变患者术后临床疗效的影响研究

Study of the effect on clinical efficacy for patients with lumbar degenerative disease by postoperative application of integrative rehabilitation model

目的评估术后应用一体化康复模式对腰椎退行性变患者临床疗效的影响。方法纳入2015年6月-2016年1月在我院因腰椎退行性疾病行腰椎管减压植骨融合内固定术的患者100例为研究对象,随机分为对照组(50例)和观察组(50例),对照组患者术后采用常规的骨科康复模式进行护理,观察组患者采用一体化的骨科康复模式进行护理。评估两组患者的临床治疗效果,于术前和术后不同时间点采用视觉模拟评分法(VAS)评估患者疼痛程度,采用改良Oswestry功能障碍指数(ODI)评估患者神经功能的恢复情况,及患者对护理的满意度。结果两组临床治疗效果比较差异无统计学意义(P>0.05)。两组患者术后VAS评分均明显低于手术前,治疗前和治疗后的差异有统计学意义(P<0.05);且观察组术后各时间点VAS评分均明显低于对照组同期的VAS评分,差异有统计学意义(P<0.05)。两组患者术后ODI评分均较术前明显降低,差异有统计学意义(P<0.05);且观察组术后各时间点ODI评分均明显低于对照组同期的ODI评分,差异有统计学意义(P<0.05)。观察组患者对护理的满意度为94.0%,明显高于对照组(80.0%),差异有统计学意义(P<0.05)。结论在腰椎退行性病变患者中开展术后一体化康复模式能够有效缓解患者术后的疼痛程度,促进术后功能的恢复,提高护理满意度,可作为腰椎减压术后早期首选的康复模式。

Objective To evaluate the effects on clinical efficacy for patients with lumbar degenerative disease by postoperative application of integrative rehabilitation model. Methods A total of 100 patients with lumbar degenerative diseases underwent lumbar vertebral canal decompression and internal fixation from June 2015 to January 2016 at our hospital were enrolled in this study. All the patients were randomly divided into the control group （50 cases） and the observation group （50 cases）. Patients in the control group received conventional nursing care after surgery, and pa- tients in the observation group were given integrative rehabilitation model after surgery. Clinical efficacy was evalua- ted in both groups. Surgery visual analogue score scale （VAS） was used to evaluate the degree of pain before and af- ter surgery, and modified Oswestry disability index （ODI） was used to evaluate the recovery of neurological function after surgery. The patients＇ recovery of neurological function and nursing satisfaction was evaluated. Results The clinical efficacy in observation group was higher than that in the control group. There was no significant difference between two group （P〈0.05）. There was no significant difference in VAS score between the two groups before op- eration, （P〈0.05）. After surgery, the VAS scores of the two groups were significantly lower than that of before operation （P〈0.05）. VAS score at each time point in the observation group was significantly lower than that of the control group （P〈0.05）. Before surgery, the ODI score of both groups was very similar. There was no significant difference between the two groups （P〈0.05）. After operation, the ODI scores of the two groups were significantlydecreased compared with those before the operation （P〈0.05）. And the ODI score at each time point after surgery was significantly lower in the observation group than that of the control group （P〈0.05）. The patients＇ satisfaction in the observation group was 94.0%, which was significantly higher than that in the control group （P〈0.05）. Cenclusien The integrative rehabilitation model can effectively relieve the postoperative pain for patients with lumbar degenerative disease, promote the functional recovery, and improve the nursing satisfaction, which can be used as the early rehabilitation model of lumbar spine surgery.