综合干预对腰椎间盘突出症患者术后康复的影响

Effects of comprehensive intervention on postoperative rehabilitation of patients with lumbar disc herniation

目的探讨综合干预对行经椎间孔椎体间融合术(TLIF)腰椎间盘突出症患者术后康复的影响。方法将120例行TLIF腰椎间盘突出症患者根据其护理管理方案分为研究组62例和对照组58例。对照组患者采用常规康复护理模式,研究组患者采用综合干预康复护理模式。比较两组患者治疗前后应对方式、疾病认知度、自我护理能力和腰椎功能,并对两组患者术后康复依从性进行评估。结果干预后,两组患者简易应对方式问卷(SCSQ)的积极应对维度评分均高于干预前,消极应对维度评分均低于干预前,且研究组优于对照组(P<0.01);研究组患者康复依从性评分和疾病认知度量表各项目评分均高于对照组(P<0.05或0.01);两组患者自我护理能力量表(ESCA)评分均高于干预前,且研究组高于对照组(P<0.01);两组患者Oswestry功能障碍指数(ODI)、视觉疼痛模拟评分量表(VAS)评分低于干预前,日本骨科协会评估治疗分数(JOA)评分高于干预前,且研究组优于对照组(P<0.01)。结论综合干预可改善TLIF腰椎间盘突出症患者疾病应对方式,提高患者术后康复依从性、疾病认知程度及自我护理能力,进一步改善腰椎功能。

Objective To explore the effects of comprehensive intervention on postoperative rehabilitation of lumbar disc herniation(LDH)patients undergoing transforaminal lumbar interbody fusion(TLIF).Methods A total of 120 LDH pat ients undergoing the TLIF were divided into research(n=62)and cont rol group(n=58)according to nursing management program.Controls received routine rehabilitation nursing model and observation group did comprehensive rehabilitation nursing model.Such indexes were compared between two groups as pre-and post-treatment coping styles,illness perception,self-care ability,and lumbar function;postoperative rehabilitation compliance of two groups was assessed.Results After intervention,scores on positive coping of the Simplified Coping Style Questionnaire(SCSQ)were higher and negative coping lower in both groups compared with pre-intervention,and those better in research than control group(P<0.01);rehabilitation compliance score and each item score of illness perception were higher in research than control group(P<0.05 or 0.01);scores on the Exercise of Self-care Agency Scale(ESCA)in both groups were higher compared with pre-intervention and so was that in research than control group(P<0.01);scores on the Oswestry Disability Index(ODI)and Visual Analogue Scale(VAS)were lower and those on the Japanese Orthopaedic Association(JOA)higher in both groups compared with pre-intervention,those better in research than control group(P<0.01).Conclusion Comprehensive intervention can effectively improve patients'coping styles with diseases,raises postoperative rehabilitation compliance,illness perception,self-care ability,and fur ther improves lumbar function.