基于思维导图的康复训练在颈椎间盘突出症患者术后康复和院后康复中的应用价值分析

Analysis of application of mind map-based rehabilitation training in postoperative rehabilitation and post-hospital rehabilitation of patients with cervical disc herniation

目的分析基于思维导图的康复训练在颈椎间盘突出症(cervical disc herniation,CDH)患者术后康复和院后康复中的应用价值。方法选取2018年6月至2020年6月上海交通大学附属第六人民医院收治的116例CDH患者为研究对象,使用简单随机法将入选患者分别纳入研究组和对照组,每组各58例,所有患者均行Bryan椎间盘置换术治疗,并行常规围手术期康复训练和健康教育,研究组患者在对照组基础上加用基于思维导图的康复训练和健康教育。比较两组患者术后并发症发生情况、出院前出院准备度量表(readiness for hospital discharge scale,RHDS)评分、出院前出院指导质量量表(quality of discharge teaching scale,QDTS)评分、颈椎活动范围、颈椎中立位曲度、手术节段Cobb角以及术前、出院前、出院后3个月视觉模拟评分法(visual analogue scale,VAS)、日本骨科协会(Japanese Orthopaedic Association,JOA)评分。结果研究组患者出院前RHDS、QDTS各维度评分和总分均显著高于对照组(均P<0.05)。两组患者出院前、出院后3个月VAS评分均显著低于本组术前(均P<0.05),颈椎JOA评分均显著高于本组术前(均P<0.05),颈椎活动范围、颈椎中立位曲度均显著大于本组术前(均P<0.05)。研究组患者出院前、出院后3个月VAS评分均显著低于同期对照组(均P<0.05),颈椎JOA评分均显著高于同期对照组(均P<0.05),颈椎活动范围、颈椎中立位曲度均显著大于同期对照组(均P<0.05)。对照组患者出院后3个月手术节段Cobb角显著大于本组术前(P<0.05),研究组患者出院后3个月手术节段Cobb角显著小于对照组(P<0.05)。两组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论基于思维导图开展康复训练不仅能够提高CDH患者出院准备度、出院指导质量,还可减轻疼痛和改善临床症状,并在保留颈部生理活动度的基础上提高神经功能。

Objective To analyze the value of mind map-based rehabilitation training in postoperative rehabilitation and post-hospital rehabilitation of patients with cervical disc herniation(CDH).Method One hundred and sixteen patients with CDH who were admitted to Sixth People's Hospital Affiliated to Shanghai Jiaotong University from June 2018 to June 2020 were randomly divided into study group and control group,with 58 cases in each group.All patients received Bryan disc replacement therapy,routine perioperative rehabilitation training and health education.In study group,mind map-based rehabilitation training and health education were added on the basis of control group.Two groups were compared in the occurrence of postoperative complications,readiness for hospital discharge scale(RHDS),quality of discharge guidance scale(QDTS)score,cervical range of motion,cervical neutral curvature,Cobb angle of surgical segment,and the visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)scores before operation,before and three months after discharge.Result The scores and total scores of RHDS and QDTS before discharge in study group were significantly higher than those in control group(all P<0.05).The VAS scores of the patients in the two groups before and three months after discharge were significantly lower than those in the same group before operation(all P<0.05),the JOA score of cervical spine was significantly higher than that in the same group before operation(all P<0.05),and the cervical range of motion and neutral cervical curvature were significantly greater than those in the same group before operation(all P<0.05).The VAS scores of the patients in study group before and three months after discharge were significantly lower than those in control group(all P<0.05),the JOA score of cervical spine was significantly higher than that in control group(all P<0.05),and the cervical range of motion and cervical neutral curvature were significantly greater than those in control group(all P<0.05).The Cobb angle of surgical segment in control group three months after discharge was significantly greater than that before operation in this group(P<0.05),and the Cobb angle of surgical segment in study group three months after discharge was significantly smaller than that in control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Mind map-based rehabilitation training can not only improve the readiness of CDH patients for discharge and the quality of discharge guidance,but also improve the pain and clinical symptoms of patients,and improve neurological function while retaining the physiological activity of the neck.