Effect of nurse-led integrated orthopedic rehabilitation after lumbar surgery
-
摘要: 目的 探讨腰椎术后以护士为主导的骨科康复一体化模式的康复效果。 方法 选择235例诊断为腰椎退行性变,行单节段腰椎后路植骨融合内固定术的患者,按住院先后顺序分为对照组118例和观察组117例,对照组实施传统康复模式,观察组实施以护士为主导的骨科康复一体化模式,于手术前和手术后7 d、1个月、3个月、6个月采用Oswestry功能障碍指数(ODI)和腰椎日本骨科学会(JOA)评分评估腰椎功能,数字疼痛评分法(NRS)评估疼痛程度。 结果 2组患者术前及术后7 d的NRS评分、JOA评分、ODI评分无统计学差异(P > 0.05); 观察组患者术后1、3、6个月NRS评分、ODI评分显著低于对照组(P < 0.05),术后3、6个月JOA评分改善率显著高于对照组(P < 0.05)。 结论 以护士为主导的骨科康复一体化模式可以缓解腰椎管减压植骨融合内固定术患者的术后疼痛,提高腰椎功能改善率。Abstract: Objective To explore the establishment of nurse-led integrated model of orthopedic rehabilitation after lumbar surgery. Methods A total of 235 patients diagnosed as lumbar degeneration undergoing single segmental lumbar posterior bone graft fusion and internal fixation were divided into control group with 118 cases and observation group with 117 cases of according to the order of admission. The control group implemented the traditional recovery mode, while the observation group implemented nurse-led integrated model of orthopedic rehabilitation. The Oswestry Disability Index(ODI)and Japanese Orthopaedic Association(JOA)score were used to evaluate lumbar function, and Number-rating Scale(NRS)was used to assess the degree of pain before the surgery, at 7 d, 1 month, 3 months, 6 months after operation were compared. Results There were no significant differences in NRS, JOA scores and improved ODI score between the two groups before surgery and at 7 d after surgery(P > 0.05). Scores ofNRS and improved ODI in the observation group were lower than those in the control group at 1, 3 and 6 months after surgery(P < 0.05), and JOA improvement rates at 3 and 6 months after surgery were lower than those in the control group(P < 0.05). Conclusion Nurse-led integrated model of orthopedic rehabilitation can alleviate the postoperative pain of patients undergoing internal fixation of lumbar canal decompressed bone grafting and improve the rate of lumbar function.
-
Keywords:
- rehabilitation integration /
- bone department /
- nursing /
- lumbar spinal stenosis
-
-
腰椎管狭窄症手术治疗规范中国专家共识组. 腰椎管狭窄症手术治疗规范中国专家共识(2014年)[J]. 中华医学杂志, 2014, 94(35): 2724-2725. Suri P, Miyakoshi A, Hunter D J, et al. Does lumbar spinal degeneration begin with the anterior structures A study of the observed epidemiology in a community-based population[J]. BMC Musculoskelet Disord, 2011, 12: 202.
周谋望. 深入临床, 积极开展骨科康复[J]. 中国康复医学杂志, 2003, 18(9): 516-516. 周谋望. 现代骨科康复理念及其应用[J]. 中国医疗器械信息, 2007, 13(2): 18-21. 刘京宇, 周谋望, 侯树勋, 等. 腰椎退行性疾病术后康复模式研究[J]. 中国骨与关节杂志, 2016, 5(3): 183-187. 中国健康促进基金会骨病专项基金骨科康复专家委员会. 骨科康复中国专家共识[J]. 中华医学杂志, 2018, 98(3): 164-170. 孙天胜, 沈建雄, 刘忠军, 等. 中国脊柱手术加速康复—围术期管理策略专家共识[J]. 中华骨与关节外科杂志, 2017, 10(4): 271-279. 周嫣,冯芳茗,陈婕, 等. 护士主导的电话随访提升心脏疾病患者自我效能的效果[J]. 解放军护理杂志, 2014, 31(19): 61-63. 倪云霞, 刘素珍, 李继平, 等. 护士主导的管理模式对社区糖尿病患者血糖控制及就医行为的影响[J]. 中华护理杂志, 2017, 52(2): 222-227. 吕桂兰, 周婷婷, 王青尔, 等. 护士主导的专病一体化管理模式在腹膜透析患者随访中的应用[J]. 医学研究生学报, 2014, 27(8): 854-856. 吕艳伟, 田伟, 刘亚军, 等. 北京地区18岁以上人群腰椎退行性疾病患病率及分布特征研究[J]. 中华骨科杂志, 2013, 33(10): 1042-1047. Hart R A, Marshal L M, Hiratzka S L, et al. Functional limitations due to stifnes as a colateral impact of instrumented arthrodesis of the lumbar spine[J]. Spine(Phila Pa 1976), 2014, 39(24): 1468-1474.
武建全, 滕勇, 陈建常. 腰椎融合术围术期镇痛药物应用的研究进展[J]. 中华实用诊断与治疗杂志, 2018, 32(3): 298-300. McGregor A H, Probyn K, Cro S, et al. Rehabilitation following surgery for lumbar spinal stenosis[J]. A Cochrane review. Spine, 2014, 39(13): 1044-1054.
-
期刊类型引用(2)
1. 郭红歌. 人工上油应用于轴节类手术器械的效果分析. 辽宁医学杂志. 2019(02): 101-103 . 
百度学术
2. 李秀英, 路珊珊. 一起灭菌后手术器械表面液体珠现象的调查. 中国感染控制杂志. 2019(07): 684-686 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 301
- HTML全文浏览量: 87
- PDF下载量: 14
- 被引次数: 2
下载:
苏公网安备 32100302010246号