认知行为干预介导退变性腰椎手术患者康复效果的系统评价

Cognitive behavior intervention-mediated rehabilitation in patients with degenerative lumbar surgery: a systematic evaluation

目的系统评价认知行为干预的实施对退变性腰椎手术患者康复效果的影响。方法计算机检索Cochrane图书馆、PubMed、EMBASE、Medline、CNKI、Wanfang 6个中英文数据库关于退变性腰椎手术患者认知行为干预的随机对照试验,2名研究人员独立检索并提取数据,使用RevMan5.3软件进行Meta分析。结果纳入7篇文献的Meta分析结果显示,试验组Oswestry功能障碍指数问卷[MD=-9.55,95%CI(-11.09^-8.02)],疼痛VAS评分[MD=-1.06,95%CI(-1.70^-0.41)],畏惧运动信念(TSK)[MD=-0.84,95%CI(-1.41^-0.28)],均明显优于对照组,差异有统计学意义(Z=12.21、3.21、2.93,P<0.01)。结论围手术期融入认知行为干预可减轻患者术前的焦虑程度,有效提高术后的自我疼痛管理水平及参与康复锻炼的积极性,降低功能性残疾程度,改善术后远期生命质量。

Objective To systematically evaluate the effects of the implementation of the cognitive behavior intervention program on the rehabilitation of patients with degenerative lumbar spine surgery. Methods 6 Chinese-English databases, The Cochrane library, PubMed, EMBASE, Medline, CNKI, Wanfang, were used for the randomized controlled trial of cognitive behavioral intervention in patients undergoing degenerative lumbar surgery. Two researchers independently retrieved and extracted data and conducted meta-analysis using RevMan5.3 software. Results The meta analysis results of 7 literatures showed that the Oswestry dysfunction index questionnaire [MD=-9.55, 95%CI(-11.09,-8.02)] in the experimental group, pain VAS score [MD=-1.06, 95%CI(-1.70,-0.41)], fear of sport belief (TSK)[MD=-0.84, 95%CI(-1.41,-0.28)] were significantly superior to the control group (Z=12.21, 3.23, 2.93, P<0.01). The difference was statistically significant. Conclusion Perioperative cognitive behavior intervention can alleviate preoperative anxiety, effectively improve postoperative self-pain management level and the enthusiasm to participate in rehabilitation exercise, reduce the degree of functional disability, and improve the long-term quality of life after surgery.