腰椎退变性疾病患者行腰椎融合术后居家康复行为及影响因素的前瞻性纵向研究  

Rehabilitation Behaviors and the Influencing Factors of Patients with Lumbar Degeneration undergone Lumbar Spine Fusion Surgery:A Prospective Cohort Study

作　　者：耿笑微[1] 朱薇[2] 许蕊凤[2] 孙垂国[2] 

机构地区：[1]北京大学护理学院,北京市100191 [2]北京大学第三医院骨科

出　　处：《中国全科医学》2012年第25期2892-2895,共4页Chinese General Practice

基　　金：北京大学医学部校级资助(BMU20090500)

摘　　要：目的了解腰椎退变性疾病患者行腰7椎融合术后1年内居家康复行为的变化特点及影响因素。方法采用前瞻性纵向研究方法,采用问卷调查的方法,于术后1个月、3个月、6个月、12个月采用电话随访或入院随访的方法进行资料的收集。随访的主要内容有康复行为实施情况和康复行为自评影响因素。结果共随访169例腰椎融合术后患者。(1)康复行为情况:85.8%(145/169)和92.3%(156/169)的患者术后进行踝泵练习和直腿抬高练习,所有患者均能够坚持练习至术后1个月以上;91.1%(154/169)的患者术后进行了腰背肌功能锻炼,45.5%(70/154)的患者腰背肌锻炼时间为6个月以上。(2)术后3个月内,选择"锻炼时害怕腰痛或腿痛"、"锻炼时害怕导致内固定松动或断裂"、"锻炼时害怕伤口疼痛"的人数较多(术后1个月为84人,术后3个月为114人)。结论腰椎退变性疾病术后患者踝泵运动及直腿抬高运动依从性良好,腰背肌运动持续性较差,术后3个月内康复锻炼可能引起的疼痛或伤害性后果是腰椎退变性疾病术后患者康复行为的主要影响因素。提示针对行腰椎固定融合术后患者的社区干预必不可少。Objective To investigate the change characteristics of rehabilitation behaviors and the influential factors of patients with lumbar degeneration disease who underwent lumbar spine fusion surgery within one year. Methods The prospective cohort study and questionnaire survey were employed. The data of the patients l month, 3 months, 6 months, and 12 months af- ter the surgery were collected by telephone interview or personal interview. The main contents of follow - up included the perform- ance of major rehabilitation behavior and the self - evaluated influential factors. Results A total 159 patients had been followed up successfully. （ 1 ） 85.8% （145/169） and 92. 3% （156/169） of the patients had been doing ＂ ankle - pump＂ exercise and ＂ straight leg raising＂ exercise every day respectively within one month after the treatment; 91.1% （154/169） had been practi- cing exercise to strengthen the low back muscle after the surgery; however only 45.5% （70/154） of them kept the practicing for more than 6 months. （2） During the first 3 months after surgery, the crucial influential factors for the patients were ＂ possible low back pain or leg pain when exercising＂ ,＂ possible break - up of internal fixation when exercising＂ and ＂ pain around the op- erative incision when exercising＂, of which for 84 patients was in one - month and for 114 patients in three - month after the sur- gery. Conclusion The compliances of ＂ ankle - pump＂ and ＂ straight leg raising＂ behaviors are good generally. However, the consistency of exercise to strengthen the low back muscle is poor. The main crucial influential factors to the pot - operative reha- bilitation behavior are the pain or harmful result possibly induced by the exercise during the first 3 months after the surgery. This implicates that the community intervention is indispensable for patients who underwent the lumbar spine fusion surgery.

关 键 词：腰椎退变性疾病 腰椎融合术 康复行为 影响因素 

分 类 号：R969.3[医药卫生—药理学]