全程系统康复对老年患者单节段腰椎融合术后功能的影响  

EFFECT OF WHOLE PROCESS SYSTEMATIC REHABILITATION ON POSTOPERATIVE RECOVERY OF SENILE PATIENTS WITH SINGLE SEGMENT LUMBAR FUSION

作　　者：石秀秀[1] 秦江[1] 唐金树[1] 胡鸢[1] 侯树勋[1] 曹晶晶[1] 张铁松[1] 王晓晶[1] 王金云[1] 

机构地区：[1]解放军总医院第一附属医院骨六科,北京100048

出　　处：《中国疼痛医学杂志》2016年第9期672-676,共5页Chinese Journal of Pain Medicine

基　　金：北京市科委重大项目(D13110700490000)

摘　　要：目的：观察全程系统康复对老年患者单节段腰椎融合术后功能的影响。方法：前瞻性收集2013年7月至2015年1月确诊为腰椎退行性疾病且符合纳入及排除标准的119例患者,随机分为观察组（n=60）和对照组（n=59）。两组患者术前、术后住院期间接受同样内容的康复治疗,出院后两组采用不同康复方案,观察组患者给予家庭康复手册,定期电话指导,康复期为12周;对照组患者行传统康复。于术前、术后12周、术后24周随访并比较两组患者腰腿疼痛视觉模拟评分（visual analogue scale,VAS）、日本骨科学会评分系统（Japanese orthopedic association scoring system,JOA）腰痛评分及改良的Oswestry功能障碍指数（Oswestry disability index,ODI）评分。结果：119例患者获得满意随访,随访时间为5.3~6.8个月,平均（5.9±0.3）个月。术后12周和24周观察组VAS评分显著低于对照组,提示疼痛得到了显著改善（P〈0.01）,JOA评分显著高于对照组,提示功能得到了明显改善（P〈0.01）,ODI评分显著低于对照组,提示功能得到了明显改善（P〈0.001）;与术前相比,两组患者术后12周及24周各指标有显著性改善（P〈0.01）,与术后12周相比,两组患者术后24周各指标有显著性改善（P〈0.01）。结论：术后全程系统康复对老年患者单节段腰椎融合术后恢复有积极影响,可以有效减轻患者疼痛症状,改善其腰部功能,提高手术疗效。Objective： To observe the effect of whole process systematic rehabilitation on postoperative recovery of senile patients with single segment lumbar fusion. Methods： A total of 119 cases of senile patients with lumbar degenerative disease were randomly allocated into observation group（n =60） and control group（n =59）. Patients in the two groups received same rehabilitation pre-treatment and postoperation during the hospital stay. After discharge, patients in observation group were offered home rehabilitation manually and regular telephone guidance during the 12 weeks rehabilitation period while control group applied with traditional rehabilitation visual analogue scale（VAS）, Japanese orthopedic association scoring system（JOA）, low back pain score, and improved oswestry disability index（ODI） were evaluated preoperative and 12 and 24 weeks postoperative. Results： A total of 119 patients were followed up between 5.3 to 6.8 months. The VAS, JOA and DOI values did not exhibit significant difference between two groups before operation. 12 and 24 weeks post operation, the VAS and ODI were significantly decreased while the JOA increased in both groups, respectively（P〈0.01）. Furthermore, the VAS and ODI were decreased while the JOA increased significantly greater in observation group, compared with control group（P〈0.01）. Conclusion： The postoperative whole process systematic rehabilitation training on senile patientswith single segment lumbar fusion could effectively reduce the pain symptom, improve the waist function and the efficacy of surgery, and produce a better efficacy compared with traditional rehabilitation.

关 键 词：康复 腰椎 老年患者 随机对照实验 

分 类 号：R687.3[医药卫生—骨科学]