早期康复训练对腰椎间盘突出症术后患者腰椎功能康复及生活质量的影响
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摘要
目的探讨早期康复训练对腰椎间盘突出症术后患者腰椎功能康复及生活质量的影响。方法选取2016年1月～2017年6月腰椎间盘突出症术后患者80例,随机分为观察组与对照组。两组均予以开窗式椎间盘髓核摘除术,术后予以常规干预措施,包括病情观察、心理安慰和术前常规康复训练。观察组在对照组基础上予以早期康复训练,干预3个月。观察并比较两组患者术后功能、生活质量恢复情况及复发率。结果治疗3个月后,两组ODI评分均较前降低(P<0.05或P<0.01),且观察组治疗后下降幅度更显著(P<0.05);两组生活质量SF-36评分较前明显上升(P<0.05或P<0.01),且观察组治疗后上升幅度更显著(P<0.05);同时观察组术后1个月和术后3个月复发率均低于对照组(P<0.05)。结论早期康复训练对腰椎间盘突出症术后患者能更好的改善腰椎功能,提高生活质量,减少术后复发。
Objective To investigate the effect of early rehabilitation training on lumbar functional recovery and quality of life in the patients with lumbar disc herniation after surgery. Methods A total of 80 patients who were given lumbar disc herniation in our hospital from January 2016 to June 2017 were selected. They were randomly divided into observation group and control group. Both groups were given open-window microendoscopic discectomy, and were given routine intervention measures after surgery, including condition observation, psychological comfort and preoperative routine rehabilitation training. The observation group was given early rehabilitation training on the basis of the control group and was intervened for 3 months. The postoperative function, recovery of quality of life and recurrence rate were observed and compared between the two groups. Results After 3 months of treatment, ODI scores in both groups were lower than before(P<0.05 or P<0.01). The decrease degree in the observation group was more significant than that in the control group(P<0.05); the SF-36 quality of life scores in both groups were significantly higher than those before treatment(P<0.05 or P<0.01), and the increase degree in the observation group was more significant than that in the control group(P<0.05); at the same time, the recurrence rate in the observation group at 1 month and 3 months after operation was lower than that in the control group(P<0.05). Conclusion Early rehabilitation training can improve lumbar function,improve quality of life, and reduce postoperative recurrence in the patients with lumbar disc herniation after surgery.
Objective To investigate the effect of early rehabilitation training on lumbar functional recovery and quality of life in the patients with lumbar disc herniation after surgery. Methods A total of 80 patients who were given lumbar disc herniation in our hospital from January 2016 to June 2017 were selected. They were randomly divided into observation group and control group. Both groups were given open-window microendoscopic discectomy, and were given routine intervention measures after surgery, including condition observation, psychological comfort and preoperative routine rehabilitation training. The observation group was given early rehabilitation training on the basis of the control group and was intervened for 3 months. The postoperative function, recovery of quality of life and recurrence rate were observed and compared between the two groups. Results After 3 months of treatment, ODI scores in both groups were lower than before(P<0.05 or P<0.01). The decrease degree in the observation group was more significant than that in the control group(P<0.05); the SF-36 quality of life scores in both groups were significantly higher than those before treatment(P<0.05 or P<0.01), and the increase degree in the observation group was more significant than that in the control group(P<0.05); at the same time, the recurrence rate in the observation group at 1 month and 3 months after operation was lower than that in the control group(P<0.05). Conclusion Early rehabilitation training can improve lumbar function,improve quality of life, and reduce postoperative recurrence in the patients with lumbar disc herniation after surgery.
引文
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[17]李小银,余娜,庄文权,等.健康教育小处方在腰椎间盘突出症介入术后康复训练指导中的应用[J].中国康复医学杂志,2013,28(8):766-767.
[18]宋应豪,曾光亮,钱志远,等.可撑开通道系统辅助下显微手术治疗腰椎间盘突出症[J].中国临床神经外科杂志,2018,23(1):7-9.
[19]俞斌,黄建明,禹宝庆,等.腰椎间盘突出症行后路椎间盘镜术后综合康复训练近期疗效分析[J].中国矫形外科杂志,2016,24(3):208-212.
[20]赖利英,赖征文,朱权.早期康复干预对胸腰椎压缩性骨折保守治疗患者功能康复的影响[J].中国初级卫生保健,2016,30(9):90-91.
[2]Elseberq CL,Salziq D,Czermak P.Bioreactor expansion of human mesenchymal stem cells according to GMP requirements[J].Methods Mol Biol,2015,1283(10):199-218.
[3]Han KT,Lee HJ,Park EC,et al.Length of stay and read-mission in lumbar intervertebral disc disorder inpatients by hospital characteristics and volumes[J].Health Policy,2016,120(9):1008-1016.
[4]丁伟国,徐卫星,卢笛,等.经皮椎间孔镜与开放椎板间开窗术治疗腰椎间盘突出症的疗效分析[J].中国内镜杂志,2016,22(4):43-48.
[5]Tulloch I,Papadopoulos MC.Giant central lumbar disc herniaions:A case for the transdural approach[J].Ann RColl Surq Enql,2018,100(3):e53-56.
[6]黄震,丰键民,张琪,等.早期康复训练在腰椎间盘突出症患者术后残余腰腿痛中的应用效果研究[J].河北医药,2012,34(22):3459-3460.
[7]彭松灏,罗琳文.腹式呼吸训练结合推拿对腰椎间盘突出症患者疼痛评分、生活质量及康复效果的影响[J].湖北中医药大学学报,2017,19(6):103-105.
[8]朱召银,黎庆初,杨洋,等.显微内窥镜下髓核摘除纤维环缝合治疗腰椎间盘突出症的疗效分析[J].中国脊柱脊髓杂志,2017,27(3):213-219.
[9]Piper BF,Dibble SL,Doddm J,et al.The revised Piper Fatigue Scale:Psychometric evaluation in women with breast cancer[J].Oncol Nurs Forum,1998,25(4):677-684.
[10]王曙红.临床护理评价量表及应用[M].长沙:湖南科学技术出版社,2011:35.
[11]Zhang JP,Tang Q,Zhu LW.Electroacupuncture combined with iontophoresis of Chinese medicine for lumbar intervertebral disc herniation[J].Journal of Acupuncture and Tuina Science,2015,13(2):105-110.
[12]管新民,周建华,胡亚威,等.86例腰椎间盘突出症相关危险因素分析[J].医学综述,2014,20(15):2875-2876.
[13]朱薇,贾东林,刘晓光,等.慢性腰腿痛住院病人焦虑抑郁状态及其对疼痛的影响[J].中国疼痛医学杂志,2017,23(3):200-204.
[14]陈龙梅,王珩.腰椎间盘突出症患者抑郁、焦虑状况及影响因素分析[J].中国疼痛医学杂志,2014,20(6):437-440.
[15]陈雷敏,伍少玲,金冬梅,等.腰椎间盘突出症手术后远期疗效分析[J].中国康复医学杂志,2008,23(3):260-261.
[16]张月兰,代名彩.中药熏蒸联合超短波治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2105,37(2):122-124.
[17]李小银,余娜,庄文权,等.健康教育小处方在腰椎间盘突出症介入术后康复训练指导中的应用[J].中国康复医学杂志,2013,28(8):766-767.
[18]宋应豪,曾光亮,钱志远,等.可撑开通道系统辅助下显微手术治疗腰椎间盘突出症[J].中国临床神经外科杂志,2018,23(1):7-9.
[19]俞斌,黄建明,禹宝庆,等.腰椎间盘突出症行后路椎间盘镜术后综合康复训练近期疗效分析[J].中国矫形外科杂志,2016,24(3):208-212.
[20]赖利英,赖征文,朱权.早期康复干预对胸腰椎压缩性骨折保守治疗患者功能康复的影响[J].中国初级卫生保健,2016,30(9):90-91.