显微镜下腰椎间盘摘除术治疗腰椎间盘突出症90例观察与护理

Observation and Nursing Care of 90 Cases of Lumbar Disc Herniation Treated by Lumbar Discectomy Under Microscope

目的分析90例腰椎间盘突出症的患者接受显微镜下腰椎间盘摘除术治疗的效果以及对腰部功能、疼痛程度、术后并发症发生情况、生活质量的影响。方法将我院收治的90例患者作为对象进行研究,患者入院时间分布在2020年10月至2022年10月之间,且均确诊为腰椎间盘突出症疾病。根据随机数字表法将患者分为两组,分别是研究组和对照组,45例/组。两组患者均接受显微镜下腰椎间盘摘除术治疗,其中对照组接受常规护理干预,研究组接受围手术期综合护理干预。对比两组术后指标、Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟评分(VAS)、术后并发症发生情况、生活质量。结果经由统计分析,研究组患者排气时间、肠鸣音恢复时间以及离床活动时间均短于对照组患者(P<0.05),且研究组患者住院时间比对照组患者短(P<0.05)。两组患者手术治疗前ODI、VAS以及JOA指标评分比较结果为P>0.05;术后3个月,两组患者ODI和VAS评分均明显下降,而且研究组患者ODI和VAS评分低于对照组患者,两组患者JOA评分均明显上升,而且研究组患者JOA评分高于对照组患者,均P<0.05。研究组与对照组术后并发症发生率比较(8.89%vs.26.67%,P<0.05)。术前,两组患者身体、角色、心理、社交等生活质量评分比较结果为P>0.05;术后3个月,两组患者上述各项评分均明显升高,且研究组患者高于对照组患者(P<0.05)。结论接受显微镜下腰椎间盘摘除术治疗的腰椎间盘突出症患者于围手术期接受综合护理干预,患者术后康复速度明显增快,腰部功能明显改善,腰部疼痛感以及功能障碍程度有效减轻,同时术后并发症发生风险减小,提高患者生活质量。

Objective To analyze the effect of lumbar disc excision under microscope on lumbar function,pain degree,postoperative complications and quality of life in 90 patients with lumbar disc herniation.Methods 90 patients admitted to our hospital from October 2020 to October 2022 were studied,and all of them were diagnosed with lumbar disc herniation.According to random number table method,the patients were divided into two groups,namely study group and control group,45 cases/group.The patients in both groups received microscopically removed lumbar intervertebral disc.The control group received routine nursing intervention,and the study group received perioperative comprehensive nursing intervention.Postoperative indexes,Oswestry Disability Index(ODI)score,visual analogue pain(VAS)score,postoperative complications,and quality of life were compared between the two groups.Results Through statistical analysis,the exhaust time,bowel sound recovery time and the time to get out of bed in the study group were shorter than those in the control group(P<0.05),and the hospital stay in the study group was shorter than that in the control group(P<0.05).The scores of ODI,VAS and JOA before operation were compared between the two groups,P>0.05.Three months after surgery,ODI and VAS scores of patients in both groups decreased significantly,ODI and VAS scores of patients in the study group were lower than those in the control group,and JOA scores of patients in the two groups were significantly increased,JOA scores of patients in the study group were higher than those in the control group,both P<0.05.The incidence of postoperative complications was compared between the study group and the control group(8.89%vs.26.67%,P<0.05).Before surgery,the scores of physical,role,psychological and social quality of life were compared between the two groups,P>0.05.Three months after surgery,the above scores were significantly increased in both groups,and the study group was higher than the control group(P<0.05).Conclusions The patients with lumbar disc herniation who underwent microtomy received comprehensive nursing intervention during perioperative period,the postoperative recovery speed of the patients was significantly increased,the lumbar function was significantly improved,the degree of lumbar pain and functional dysfunction was effectively alleviated,the risk of postoperative complications was reduced,and the quality of life of the patients was improved.