术前预适应训练联合心理干预应用于老年OVCF PKP手术患者的效果

Effect of preoperative preconditioning training combined with psychological intervention on elderly patients undergoing OVCF PKP surgery

目的:探讨术前预适应训练联合心理干预应用于老年骨质疏松性椎体压缩骨折(Osteoporotic vertebral body compression fractures,OVCF)经皮椎体后凸成形术(Percutaneous vertebral body kyphoplasty,PKP)手术患者的效果。方法:选取2021年8月至2022年8月期间于我院就诊的老年OVCF患者90例,随机分为对照组和观察组,两组各45例。对照组给予常规心理干预,观察组在对照组基础上给予术前预适应训练干预,观察两组术中生命体征变化情况、功能障碍情况及疼痛情况。结果:两组患者心率(Heart rate,HR)、平均动脉压(Mean arterial pressure,MAP)水平均较入室时升高,观察组水平低于对照组(P<0.05);两组患者血氧饱和度(Oxygen saturation of blood,SpO_(2))水平均较入室时降低,观察组水平高于对照组(P<0.05);手术后3d,两组患者Oswestry功能障碍指数(Oswestry dysfunction index,ODI)各维度均较手术前降低,且观察组患者低于对照组(P<0.05);手术后1d,两组患者视觉模拟评分法(Visual analogue scales,VAS)疼痛评分均较手术前降低,且观察组患者低于对照组(P<0.05);两组患者手术后1d椎体高度比较差异无统计学意义。结论:术前预适应训练联合心理干预可以稳定老年OVCF患者PKP术中的生命体征情况,改善术后功能障碍情况,降低疼痛水平,且不会影响手术治疗效果。

Objective:To investigate the effect of preoperative preconditioning training combined with psychological intervention on elderly patients undergoing OVCF PKP surgery.Methods:A total of 90 elderly OVCF patients treated in our hospital from August 2021 to August 2022 were selected and divided into control group and observation group randomly,with 45 cases in both groups.The control group was given routine psychological intervention,and the observation group was given preoperative pre-adaptation training intervention on the basis of the control group.The changes of vital signs,dysfunction and pain degrees in the two groups were observed.Results:The levels of HR and MAP in both groups were higher than those in the control group(P<0.05).The level of SpO_(2) in both groups was lower than that at the time of admission,and the level in observation group was higher than that in control group(P<0.05).At 3 days after operation,ODI in both groups was lower than that before operation,and that in observation group was lower than that in control group(P<0.05).One day after operation,VAS scores in both groups were lower than that before operation,and VAS in observation group was lower than that in control group(P<0.05).There were no significant differences in the vertebral height between two groups.Conclusion:Preoperative preconditioning training combined with psychological intervention can stabilize the vital signs of elderly OVCF patients during PKP operation,improve the postoperative dysfunction and reduce the level of pain,not affect the surgical effect.