延续性康复护理对腰椎间盘突出症患者微创术后康复的影响

Effects of continuous rehabilitation nursing on postoperative recovery of patients with minimally invasive lumbar disc herniation

目的 探讨延续性康复护理模式对微创腰椎间盘突出症术后功能恢复的影响.方法 2011年3月—2016年3月采用便利抽样法选择浙江省绍兴市人民医院康复中心进行康复锻炼的微创腰椎间盘突出症术后患者115例,按照随机数字表分为对照组（n=58）和观察组（n=57）,两组患者均予一级和二级康复护理,观察组出院后在家庭或社区予以延续性康复护理,对照组中断延续性康复护理,患者在家自行锻炼.观察两组患者在术前、术后1个月和术后3个月的Oswstry功能障碍指数（ODI）和日本骨科协会评估治疗分数（JOA）,同时比较两组患者随访3个月的护理治疗效果.结果 术前、术后1个月和术后3个月,对照组的ODI评分分别为（37.59±6.03）、（8.31±2.75）、（1.95±1.16）分,观察组分别为（38.61±5.69）、（7.95±2.06）、（1.18±0.85）分,术前和术后1个月两组比较差异无统计学意义（t值分别为0.882、0.641;P〉0.05）,术后3个月观察组评分低于对照组,差异有统计学意义（t=16.571,P〈0.01）.术前、术后1个月和术后3个月,对照组的JOA评分分别为（11.43±2.17）、（18.60±2.20）、（21.87±2.07）分,观察组为（10.79±2.02）、（18.96±3.54）、（27.14±2.36）分,术前和术后1个月两组比较差异无统计学意义（t值分别为1.697、0.434;P〉0.05）,术后3个月观察组评分高于对照组,差异有统计学意义（t=161.998,P〈0.01）.随访3个月后对两组护理治疗效果进行评价,观察组的总有效率高于对照组（91.2%,74.1%）,差异有统计学意义（Z=3.087,P〈0.01）.结论 通过规范化的延续性康复护理,可以改善椎间盘突出症患者微创术后的腰椎功能和脊髓神经功能,提高患者的康复效果.

Objective To explore the effects of continuous rehabilitation nursing on the postoperative functional recovery of patients with minimally invasive lumbar disc herniation.Methods Totally 115 postoperative patients with minimally invasive lumbar disc herniation who were admitted into the rehabilitation center of Shaoxing People′s Hospital of Zhejiang Province for rehabilitation exercise between March 2011 and March 2016 were selected by convenience sampling method and were divided into the control group （n=58） and the observation group （n=57） by random number table. Patients in two groups were given grade-one and grade-two rehabilitation nursing. After discharged from hospital,patients in the observation group were given continuous rehabilitation nursing in their family or community,while patients in the control group,whose continuous rehabilitation nursing was suspended,were required to do exercise at home. Then the scores of Oswstry disability index （ODI） and Japanese Orthopaedic Association score（JOA） before operation,one month after operation and three months after operation in two groups were observed,and the effects of their three-month′ nursing and treatment were compared.Results The ODI scores of the control group before operation,one month after operation and three months after operation were [（37.59±6.03）,（8.31±2.75）,（1.95±1.16）],and those of the observation group were [（38.61±5.69）,（7.95±2.06）,（1.18±0.85）] （t=0.882,0.641;P〉0.05）;the score of the observation group three months after operation was lower than that of the control group （t=16.571,P〈0.01）. The JOA scores of the control group before operation,one month after operation and three months after operation were [（11.43±2.17）,（18.60±2.20）,（21.87±2.07）],and those of the observation were [（10.79±2.02）, （18.96±3.54）,（27.14±2.36）] （t=1.697,0.434;P〉0.05）;the observation group′s score three months after operation was higher than that of the control group （t=161.998,P〈0.01）. As for the effects of two groups three months after treatment,the total efficacy of the observation group was higher than that of the control group （91.2% vs 74.1%） （Z=3.087,P〈0.01）.Conclusions Normalized continuous rehabilitation nursing can help to improve the lumbar and spinal cord functions of patients with minimally invasive lumbar disc herniation after operation and enhance their rehabilitation efficacy.