电针联合运动疗法治疗胸腰椎爆裂性骨折术后康复效果观察

Effect of Electroacupuncture Combined with Exercise Therapy on Postoperative Rehabilitation of Thoracolumbar Burst Fracture

目的探究电针联合运动疗法在胸腰椎爆裂性骨折术后康复治疗中的效果。方法纳入76例胸腰椎爆裂性骨折术后患者(2020年8月—2021年7月收治)进行研究,采取随机数字表法将纳入的76例患者平均分成对照组和观察组,各38例。对照组患者术后进行运动疗法治疗,观察组患者在对照组治疗基础上结合电针治疗。比较疗效、并发症、治疗前后中医证候(骨折、疼痛肿胀、瘀斑、便秘尿赤、口渴等)积分、下床活动时间及住院时间、伤锥形态参数(前缘高度及矢状面后凸Cobb角)变化、腰背部功能(改良Oswestry功能障碍指数,ODI)改善情况、治疗前后疼痛量表评分(VAS)及生活能力情况(Barthel指数)变化。结果与对照组(78.95%,30/38)相比,观察组有效率(94.74%,36/38)更高(P<0.05);与对照组(10.53%,4/38)比较,观察组患者术后并发症率(0.00%,0/0)更低(P<0.05);治疗前,两组患者中医证候(骨折、疼痛肿胀、瘀斑、便秘尿赤、口渴等)积分、伤锥形态参数(前缘高度及矢状面后凸Cobb角)、VAS及Barthel指数比较(P>0.05),治疗后各组患者中医证候(骨折、疼痛肿胀、瘀斑、便秘尿赤、口渴等)积分、伤锥形态参数(前缘高度及矢状面后凸Cobb角)、VAS Barthel指数均改善,观察组患者治疗后中医证候(骨折、疼痛肿胀、瘀斑、便秘尿赤、口渴等)积分、伤锥形态参数(前缘高度及矢状面后凸Cobb角)、VAS及Barthel指数优于对照组(P<0.05);与对照组比较,观察组患者下床活动时间及住院时间均更短(P<0.05);与对照组(81.58%,31/38)比较,观察组患者(97.37%,37/38)术后腰背部功能优良率更高(P<0.05)。结论电针联合运动疗法在胸腰椎爆裂性骨折术后康复治疗中的效果良好,患者术后症状改善,并发症率低,腰背部功能恢复好,生活质量提升,值得应用。

Objective To explore the effect of electroacupuncture combined with exercise therapy on postoperative rehabilitation of thoracolumbar burst fracture.Methods A total of 76 patients with thoracolumbar burst fracture surgery(admitted from August 2020 to July 2021)were included in the study.The patients were divided into the control group and the observation group by random number table method,with 38 patients in each group.The patients in the control group were treated with exercise therapy after surgery and those in the observation group were treated with electroacupuncture on the basis of treatment in the control group.The efficacy,complications,TCM syndrome scores(fracture,pain and swelling,ecchymosis,constipation and urine redness,thirst,etc.)before and after treatment,the time of movement out of bed and length of hospital stay,changes in cone shape parameters(leading edge height and sagittal kyphosis Cobb Angle),lumbar and back functions(modified Oswestry disability index,ODI),VAS and Barthel index before and after treatment were compared.Results Compared with the control group(78.95%,30/38),the effective rate of the observation group(94.74%,36/38)was higher(P<0.05).Compared with that of the control group(10.53%,4/38),the postoperative complication rate of the observation group(0.00%,0/0)was lower(P<0.05).Before treatment,the scores of TCM syndromes(fracture,pain and swelling,ecchymosis,constipation and urine redness,thirst,etc.),morphology parameters of injured cone(leading edge height and sagittal kyphosis Cobb Angle),VAS and Barthel index of two groups had no significance(P>0.05).After treatment,the TCM syndrome scores(fracture,pain and swelling,ecchymosis,constipation and urine redness,thirst,etc.),morphology parameters of injured cone(frontal height and sagittal kyphosis Cobb Angle),VAS Barthel index were improved in both groups.The scores of TCM syndrome(fracture,pain and swelling,ecchymosis,constipation and urine redness,thirst,etc.),morphology parameters of injured cone(frontal height and sagittal kyphosis Cobb Angle),VAS and Barthel index in the observation group were better than those in the control group(P<0.05).Compared with that of the control group,the time of ambulation and hospitalization in observation group was shorter(P<0.05).Compared with that of the control group(81.58%,31/38),the excellent rate of lumbar back function was higher in the observation group(97.37%,37/38)(P<0.05).Conclusion Electroacupuncture combined with exercise therapy has a good effect on postoperative rehabilitation of thoracolumbar burst fracture,with improved postoperative symptoms,low complication rate,good recovery of lumbar and back functions and improved quality of life,and is worthy of application.