基于Cox健康行为互动模式的腰椎术后综合征预防管理方案的构建及应用

Construction and application of a prevention and management program for lumbar postoperative syndrome based on the interaction model of client health behavior

目的改善腰椎退行性疾病患者术后腰椎功能,减轻疼痛,促进患者健康结局。方法按照入院时间将行腰椎后路手术的106例腰椎退行性疾病患者分为对照组及观察组各53例,对照组实施术后常规护理,观察组实施基于Cox健康行为互动模式的腰椎术后综合征预防管理方案。干预前后不同时间评价两组腰椎功能评分、疼痛评分及躯干偏移角度、骨盆扭转角度、椎体左右旋转最大角度之和。结果干预后1周、1个月、3个月观察组疼痛评分显著低于对照组,两组组间效应、时间效应差异有统计学意义(均P<0.05);干预后3个月、6个月观察组腰椎功能评分显著优于对照组(均P<0.05),两组组间效应、时间效应和交互效应差异有统计学意义(均P<0.05);干预后8周观察组躯干偏移角度、骨盆扭转角度及椎体左右旋转最大角度之和显著低于对照组(均P<0.05)。结论实施基于Cox健康行为互动模式的腰椎术后综合征预防管理方案,有利于缓解腰椎后路手术患者术后疼痛程度,提高腰椎稳定性及腰椎功能,促进患者康复。

Objective To improve the function of lumbar spine after surgery in patients with degenerative diseases of lumbar spine,to alleviate their pain and promote their health outcomes.Methods A total of 106 patients with lumbar degenerative diseases and undergoing posterior lumbar surgery were divided into a control group and an intervention group chronologically,with 53 cases in each group.The control group received routine postoperative nursing,while the intervention group received a scheme for prevention and management of lumbar postoperative syndrome based on the interaction model of client health behavior.The score of lumbar spine function and pain,the trunk deviation angle,pelvic torsion angle and the sum of maximum angle of left and right rotation of the vertebral body were compared between the two groups at different time points before and after the intervention.Results At 1 week,1 month and 3 months after the intervention,the pain score of the intervention group were significantly lower than those of the control group,and the group effect and time effect were significant when they were compared between the two groups(all P<0.05).At 3 months and 6 months after the intervention,the scores of lumbar spine function of the intervention group were significantly higher than those of the control group,and the group effect,time effect and group×time interaction effect were significant when they were compared between the two groups(all P<0.05).At 8 weeks after the intervention,the trunk deviation angle,pelvic torsion angle and the sum of maximum angle of left and right rotation of the vertebral body in the intervention group were significantly lower than those in the control group(all P<0.05).Conclusion Implementation of the prevention and management program for lumbar postoperative syndrome based on the interaction model of client health behavior,is conducive to alleviating postoperative pain for patients undergoing posterior lumbar surgery,improving the stability and function of the lumbar spine,and enhancing their rehabilitation.