联合式康复护理用于微创手术治疗腰椎间盘突出症的效果观察

Effect of the combined rehabilitative care in minimally invasive surgery treatment of lumbar disc herniation

目的:探讨疼痛管理、情绪管理和康复路径的联合式康复护理在腰椎间盘突出症微创手术治疗中的临床价值。方法:根据数字表法将行微创手术治疗的腰椎间盘突出症病人86例随机分为对照组和观察组,每组43例。对照组病人给予常规康复护理,观察组病人给予疼痛管理、情绪管理和康复路径指引的联合式康复护理模式。对比2组病人护理干预前后的情绪、疼痛变化以及腰椎、脊髓神经功能。结果:干预前,2组汉密顿抑郁量表(HAMD)评分和视觉模拟评分法(VAS)评分差异均无统计学意义(P>0.05)。观察组病人经联合式康复护理干预后,HAMD评分和VAS评分均低于对照组(P<0.01)。干预前,2组腰痛评分标准(ODI)评分和日本骨科学会腰背痛手术评分标准(JOA)评分差异均无统计学意义(P>0.05)。观察组病人经联合式康复护理干预后ODI评分与对照组比较明显降低,JOA评分与对照组比较明显升高(P<0.01)。结论:腰椎间盘突出症微创手术病人实施联合式康复的护理模式,能明显降低不良心理情绪和疼痛程度,提高了病人的康复训练依从性和安全性,值得广泛推广。

Objective: To evaluate the clinical significance of the combined rehabilitative care( including pain management,emotional management and rehabilitation paths) in minimally invasive surgery treatment of lumbar disc herniation. Methods: Eighty-six lumbar disc herniation patients treated with minimally invasive surgery were randomly divided into the control group and observation group( 43 cases each group). The control group and observation group were nursed with routine rehabilitation nursing care and combined rehabilitative care,respectively. The emotion,pain and lumbar vertebra and spine function in two groups before and after intervention were compared. Results: Before intervention,the differences of the scores of Hamilton Depression Scale( HAMD) and visual analog score( VAS) between two groups were not statistically significant( P > 0. 05). After intervention,the scores of HAMD and VAS in observation group were lower than those in control group( P < 0. 01). Before intervention,the differences of the scores of ODI and JOA between two groups were not statistically significant( P > 0. 05). Compared with the control group,the score of ODI in observation group after intervention obviously decreased,and the score of JOA in observation group after intervention was obviously high( P < 0. 01).Conclusions: The combined rehabilitative care in minimally invasive surgery treatment of lumbar disc herniation can significantly reduce unhealthy psychological mood and level of pain,and improve the rehabilitation compliance and security of patients,which is worthy of popularization in clinic.