团队延续性中西医护理措施对保守治疗腰椎间盘突出症出院患者康复效果的影响

Effect of Team-based Transitional Nursing Measures of Integrated Chinese and Western Medicine on Rehabilitation of Discharged Patients after Conservative Treatments of Lumbar Disc Herniation

目的:评价团队延续性中西医护理措施对保守治疗腰椎间盘突出症(LDH)出院患者康复效果的影响。方法:将80例经保守治疗后出院的LDH患者按随机数字表法分为对照组和观察组40例。对照组给予常规护理,叮嘱患者坚持良好的生活方式,遵医嘱服药,指导正确掌握腰腹肌功能锻炼方法等。观察组实施由医生、护士、康复治疗师组成的团队制定的出院前教育、生活方式干预、强筋固肾功能锻炼、避免诱发因素和艾灸的综合康复护理措施。于出院后第2周、第3个月、第6个月家庭随访一次,电话随访时间是第1个月每周电话1次,以后每2周电话随访1次。评价随访6个月期间2组患者的依从性和临床疗效,于出院时、出院后3个月和6个月评价日本骨科协会(JOA)评分。结果:6个月的随访结束时,观察组临床疗效优于对照组(P<0.05),依从性高于对照组(P<0.05)。出院后3个月和6个月,2组腰部功能情况均较出院时改善(P<0.01),观察组的腰部功能情况均优于对照组(P<0.01)。结论:团队延续性的中西医护理措施对稳定LDH病情,减少复发有着较好的临床疗效。

Objective:To evaluate the effect of team-based transitional nursing measures of integrated Chinese and western medicine on the rehabilitation of discharged patients after conservative treatments of lumbar disc herniation(LDH).Methods:A total of 80 cases of discharged patients after conservative treatments of LDH were divided into the control group and the observation group according to the random number table method,40 cases in each group.The control group was given routine nursing including keeping good lifestyles,taking medicine according to medical orders and following the guidance to grasp the correct methods of functional exercise of the lumbar and abdominal muscles.The observation group was given comprehensive rehabilitation nursing measures including education before discharge,intervention of lifestyle,functional exercises of strengthening sinews and securing the kidney,measures of avoiding inducing factors and moxibustion made by a team of doctors,nurses and rehabilitation therapists.There were family follow-ups on the second week,the third month and the sixth month after discharge,once for each time;telephone follow-ups once a week in the first month and once every two weeks afterwards.The compliance and clinical effect in the two groups during the six-month follow up were evaluated;the scores of Japanese Orthopaedic Association(JOA) were evaluated at discharge and in the third and sixth month after discharge respectively.Results:At the end of the six-month follow-up,the clinical effect in the observation group was superior to that in the control group(P<0.05),and the compliance in the observation group was higher than that in the control group(P<0.05).In the third and the sixth month after discharge,the lumbar functions in the two groups were improved respectively when compared with those before discharge(P<0.01),and the lumbar function in the observation group was superior to that in the control group(P<0.01).Conclusion:The team-based transitional nursing measures of integrated Chinese and western medicine has better clinical effect in stabilizing the condition of LDH and reducing the recurrence.