早期练功对腰椎间盘突出症术后椎间隙高度及康复疗效的影响
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摘要
目的本课题通过对腰椎间盘突出症术后早期练功组与对照组的临床观察,了解术后手术椎间隙高度的变化及与康复疗效情况。探讨早期练功对术后椎间隙高度及康复疗效的影响,为今后深入研究早期练功在维持椎间隙高度及术后康复方面所起的作用,提供理论依据。
方法对2007年3月起至2007年10月期间在广州中医药大学第一附属医院脊柱骨科行开窗减压髓核摘除术的患者进行随机分为练功组和对照组,观察患者术前、术后1个月和术后6个月手术椎间隙高度及Oswestry功能障碍指数问卷表的评分(ODI)。采用严格的统计分析,对组间差异及相关因素进行研究。
结果本课题所纳入的41名患者,术后手术椎间隙高度有明显丢失,差异具有显著性(P＜0.05),练功组与对照组相比,术后6个月时手术椎间隙丢失量较少,差异具有显著性(P＜0.05)。术后6个月椎间隙最大丢失量为术前椎间隙高度的56%。两组术后ODI有明显的降低,与对照组相比练功对于患者术后ODI的影响更显著(P＜0.05)。术后6个月,手术椎间隙高度与ODI有显著负相关性(相关性系数为r=-0.423,P＜0.05)。而术后手术椎间隙丢失的高度与相邻椎间隙高度的变化量无相关关系(P＞0.05)。术后椎间隙丢失的高度与患者年龄、术中髓核摘除量均无相关关系(P＞0.05)。
结论早期练功患者术后ODI较对照组更低,康复疗效更好,提示临床上应广泛开展,提高术后康复疗效。开窗减压髓核摘除术后手术椎间隙高度在一定范围内具有显著丢失,术后早期练功对减缓手术椎间隙高度的丢失具有积极意义。而手术椎间隙高度的丢失量不受年龄和手术过程中髓核摘除量的影响。术后椎间隙高度的丢失量在一定范围内可作为评价术后康复疗效的参考依据之一。手术椎间隙高度丢失后不会对其相邻上下椎间隙的高度造成影响。开窗减压髓核摘除术对腰椎间盘突出症患者ODI具有较强的影响,术后患者康复效果明显。
Objective:In this thesis,we observe practice group and control group of Lumbar disc herniation posterior windowing postoperative patients, understanding the height of vertebrae interval and rehabilitative effect,and offer thereunder for the future lucubrate the forepart practice skill on keep the height of vertebrae interval and rehabilitative effect.
Methods:We grouping the patient of operation in The First Affilated Hospital of Guangzhou Traditional Chinese Medicine University from 2007 March to October.We observe the different between practice group and control group onthe height of vertebrae interval and the Oswestry disability index(ODI) in preoperative,one month,six month.We analyse the different between practice group and control groupand correlative factor through statistics.
Result:The height of lumbar vertebrae interval of all 41 cases have losing in various degree after operation(P＜0.05).Practice group lost fewer the height of lumbar vertebrae interval than control group on six month later (P＜0.05).And the most lost height 56%compared preoperative.ODI has reduced in postoperative,specially in the practice group(P＜0.05).After six month, there is the most negative relativity between the height of lumbar vertebrae interval and ODI(r=-0.423,P＜0.05).And there is not relationship between the height of operation vertebrae interval and the height of border upon vertebrae interval(P＞0.05).And the change of the height of operation vertebrae interval is not because of patients age and quantity of extirpated intervertebral disc(P＞0.05).
Conclusion:Compared control group,forepart practice skill patients has lower ODI and better rehabilitative effect.Forepart practice skill should be spread widely,to make the rehabilitative effect better.The height of lumbar vertebrae interval of all have losing in various degree after operation. Forepart practice skill make actively on the reducedthe height losting.And the change of the height of operation vertebrae interval is not effected by patient's age and quantity of extirpated intervertebral disc.The losted height of vertebrae interval is one of the according for rehabilitative effect. There is not relationship between the height of operation vertebrae interval and the height of border upon vertebrae interval.The posterior windowing operation is a good method for lumbar disc herniation patients and the ODI is obviously cut down.
方法对2007年3月起至2007年10月期间在广州中医药大学第一附属医院脊柱骨科行开窗减压髓核摘除术的患者进行随机分为练功组和对照组,观察患者术前、术后1个月和术后6个月手术椎间隙高度及Oswestry功能障碍指数问卷表的评分(ODI)。采用严格的统计分析,对组间差异及相关因素进行研究。
结果本课题所纳入的41名患者,术后手术椎间隙高度有明显丢失,差异具有显著性(P＜0.05),练功组与对照组相比,术后6个月时手术椎间隙丢失量较少,差异具有显著性(P＜0.05)。术后6个月椎间隙最大丢失量为术前椎间隙高度的56%。两组术后ODI有明显的降低,与对照组相比练功对于患者术后ODI的影响更显著(P＜0.05)。术后6个月,手术椎间隙高度与ODI有显著负相关性(相关性系数为r=-0.423,P＜0.05)。而术后手术椎间隙丢失的高度与相邻椎间隙高度的变化量无相关关系(P＞0.05)。术后椎间隙丢失的高度与患者年龄、术中髓核摘除量均无相关关系(P＞0.05)。
结论早期练功患者术后ODI较对照组更低,康复疗效更好,提示临床上应广泛开展,提高术后康复疗效。开窗减压髓核摘除术后手术椎间隙高度在一定范围内具有显著丢失,术后早期练功对减缓手术椎间隙高度的丢失具有积极意义。而手术椎间隙高度的丢失量不受年龄和手术过程中髓核摘除量的影响。术后椎间隙高度的丢失量在一定范围内可作为评价术后康复疗效的参考依据之一。手术椎间隙高度丢失后不会对其相邻上下椎间隙的高度造成影响。开窗减压髓核摘除术对腰椎间盘突出症患者ODI具有较强的影响,术后患者康复效果明显。
Objective:In this thesis,we observe practice group and control group of Lumbar disc herniation posterior windowing postoperative patients, understanding the height of vertebrae interval and rehabilitative effect,and offer thereunder for the future lucubrate the forepart practice skill on keep the height of vertebrae interval and rehabilitative effect.
Methods:We grouping the patient of operation in The First Affilated Hospital of Guangzhou Traditional Chinese Medicine University from 2007 March to October.We observe the different between practice group and control group onthe height of vertebrae interval and the Oswestry disability index(ODI) in preoperative,one month,six month.We analyse the different between practice group and control groupand correlative factor through statistics.
Result:The height of lumbar vertebrae interval of all 41 cases have losing in various degree after operation(P＜0.05).Practice group lost fewer the height of lumbar vertebrae interval than control group on six month later (P＜0.05).And the most lost height 56%compared preoperative.ODI has reduced in postoperative,specially in the practice group(P＜0.05).After six month, there is the most negative relativity between the height of lumbar vertebrae interval and ODI(r=-0.423,P＜0.05).And there is not relationship between the height of operation vertebrae interval and the height of border upon vertebrae interval(P＞0.05).And the change of the height of operation vertebrae interval is not because of patients age and quantity of extirpated intervertebral disc(P＞0.05).
Conclusion:Compared control group,forepart practice skill patients has lower ODI and better rehabilitative effect.Forepart practice skill should be spread widely,to make the rehabilitative effect better.The height of lumbar vertebrae interval of all have losing in various degree after operation. Forepart practice skill make actively on the reducedthe height losting.And the change of the height of operation vertebrae interval is not effected by patient's age and quantity of extirpated intervertebral disc.The losted height of vertebrae interval is one of the according for rehabilitative effect. There is not relationship between the height of operation vertebrae interval and the height of border upon vertebrae interval.The posterior windowing operation is a good method for lumbar disc herniation patients and the ODI is obviously cut down.
引文
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