术前预康复方案在腰椎退行性疾病手术患者中的应用

Effects of preoperative prehabilitation program in patients undergoing surgery for degenerative lumbar spine disease

目的:分析基于加速康复外科理念的术前预康复方案对腰椎退行性疾病手术患者的应用效果。方法:在北京市某三级甲等医院组建预康复团队,构建术前预康复方案并在临床应用,比较实施前后患者的腰椎功能状态及术后恢复情况。结果:两组患者的腰椎功能障碍指数和疼痛评分呈下降趋势,且预康复组下降趋势快于对照组。预康复组患者术后首次下床时间短于对照组,出院时Barthel评分高于对照组,差异均有统计学意义(P<0.05)。两组患者术后并发症差异无统计学意义(P>0.05)。结论:对腰椎退行性疾病手术患者实施预康复方案具有较好的临床效果,术前干预可改善患者腰椎功能状态及术后恢复,可为临床能够更好地开展加速康复外科实践提供借鉴。

Objective:To investigate the effects of a preoperative prehabilitation program based on the concept of Enhanced Recovery After Surgery(ERAS)on patients with lumbar degenerative diseases.Methods:A prehabilitation team was established in a tertiary hospital in Beijing,and a preoperative prehabilitation program was constructed.The functional status of the lumbar spine and postoperative recovery of patients was analyzed.Results:The lumbar spine dysfunction index and pain scores of patients in both groups showed a decreasing trend.The decreasing trend in the experiment group was faster group than that in the control group,the patients'first time out of bed in the experiment group was shortened than that in the control group,the Barthel score at discharge in the experiment group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The implementation of the prehabilitation program for patients with lumbar degenerative diseases has good clinical effects.The preoperative intervention can improve the functional status of patients'lumbar spine and postoperative recovery speed.It can provide useful information for the clinical practice of enhanced recovery after surgery.