基于量化评估策略的围手术期护理在腰椎滑脱症患者手术中的应用研究

Application of perioperative care based on quantitative evaluation strategy in the surgery of patients with lumbar spondylolisthesis

目的研究基于量化评估策略的围手术期护理在腰椎滑脱症患者手术中的应用效果。方法选取2020年1月至2021年12月嘉兴市第二医院收治的186例腰椎滑脱症患者进行回顾性研究。根据护理方式的不同分为对照组(n=90)与观察组(n=96)。对照组接受常规围手术期护理,观察组在对照组基础上给予基于量化评估策略的围手术期护理。比较两组的血压、心率及并发症发生情况。采用简明心境量表(brief profile of mood state,BPOMS)评估护理前后患者情绪情况,采用视觉模拟评分法(visual analogue scale,VAS)评估术后1d、3d时两组患者的疼痛情况,采用Oswestry功能障碍指数问卷表(Oswestry disability index,ODI)及日本骨科协会(Japanese Orthopaedic Association,JOA)评分评估两组术后1d、3个月的功能障碍情况。结果麻醉前,观察组血压、心率及并发症发生率均显著低于对照组(P<0.05)。护理后,两组BPOMS各项指标评分均显著低于护理前,且观察组显著低于对照组(P<0.05)。两组术后3d的VAS评分、术后3个月的ODI评分均显著低于术后1d,且观察组显著低于对照组(P<0.05)。术后3个月的JOA评分显著高于术后1d,且观察组显著高于对对照组(P<0.05)。结论基于量化评估策略的围手术期护理能有效稳定腰椎滑脱症患者血压、心率,改善其不良情绪,减少并发症,有利于患者术后功能提高,可临床进一步应用。

Objective To investigate the application effect of perioperative nursing based on quantitative evaluation strategy in patients with lumbar spondylolisthesis during surgery.Methods A total of 186 patients with lumbar spondylolisthesis admitted to Jiaxing Second Hospital from January 2020 to December 2021 were selected for a retrospective study.They were divided into a control group(n=90)and an observation group(n=96)according to the different ways of nursing.The control group received conventional perioperative nursing,while the observation group was given perioperative nursing based on quantitative evaluation strategy on the basis of the control group.Blood pressure,heart rate,mood and complication rates were compared between the two groups.The brief profile of mood state scale(BPOMS)was used to assess patients’mood before and after care.The visual analogue scale(VAS)was used to assess pain in the two groups at 1 day and 3 days postoperatively,and the Oswestry disability index(ODI)and Japanese Orthopaedic Association(JOA)scores were used to assess functional impairment in the two groups at 1 day and 3 months postoperatively.Results Before anaesthesia,the blood pressure,heart rate and complication rate of the observation group were significantly lower than those in the control group(P<0.05).After nursing,the scores of all indicators on the BPOMS were significantly lower in both groups than before nursing,and significantly lower in the observation group than those in the control group(P<0.05).In both groups,the VAS score at 3 days postoperatively and the ODI score at 3 months postoperatively were significantly lower than those at 1 day postoperatively,and the observation group was significantly lower than the control group(P<0.05).The JOA score at 3 months postoperatively was significantly higher than that at 1 day postoperatively,and the observation group was significantly higher than that in the control group(P<0.05).Conclusion Perioperative nursing based on quantitative evaluation strategy can effectively stabilize the blood pressure and heart rate of patients with lumbar spondylolisthesis,improve their bad mood,reduce complications,and be conducive to postoperative function,which can be further applied in clinic.