腰椎经皮椎间孔镜围手术期运动康复和步态分析的临床研究  

Clinical study of exercise rehabilitation and gait analysis during the perioperative period of lumbar percutaneous transforaminal endoscopic discectomy

作　　者：钟毓贤[1] 丁宇[1] 刘金玉[1] 周维金[1] 马广昊[1] 朱旭[1] 王海军[1] 陈红梅 刘倩[1] ZHONG Yu-xian;DING Yu;LIU Jin-yu;ZHOU Wei-jin;MA Guang-hao;ZHU Xu;WANG Hai-jun;CHEN Hong-mei;LIU Qian.(Department of Rehabilitation Medicine ,Navy General Hospital ,Beijing 100048, China)

机构地区：[1]中国人民解放军海军总医院康复医学科,北京100048

出　　处：《中国骨伤》2018年第4期311-316,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨围手术期运动康复对腰椎经皮椎间孔镜手术(PTED)后腰椎管狭窄症(LSS)患者的残留疼痛、步态等日常生活活动能力的临床影响。方法:对2015年12月至2016年12月收治的48例PTED术后患者进行回顾性分析研究,根据接受的康复形式不同分为观察组(接受运动康复治疗)和对照组(接受一般康复宣教),每组24例。分别于术前、术后12 d、6个月对患者的VAS、ODI评分及步行支撑相比值进行观察,并对支撑相比值与VAS、ODI相关性进行分析。结果:术后12 d,观察组支撑相比值显著大于对照组(P<0.05);术后6个月,观察组的VAS和ODI评分均显著低于对照组(均P<0.01);术后两组支撑相比值与ODI、VAS均无相关性(P>0.05)。结论:腰椎微创手术围手术期的康复训练可以缓解或消除术后残余疼痛问题,改善步行平衡性,提高日常生活活动能力。Objective：To explore the clinical effect of exercise rehabilitation during perioperative period on residual pain,gait and activities of daily living（ADL） in patients with lumbar spinal stenosis（LSS） after lumbar percutaneous transforaminal endoscopic discectomy（PTED）. Methods：The clinical data of 48 patients with LSS underwent PTED from December 2015 to December 2016 were retrospectively analyzed. Patients were divided into observation group and control group according to different rehabilitation patterns,being 24 cases in each group. The patients of observation group received exercise rehabilitation and the patients of control group received conventional rehabilitation. Visual analogue scale（VAS）,Oswestry Disability Index（ODI） and the ratio of supporting phase were recorded before operation and 12 days,6 months after operation. The correlation between the ratio of supporting phase and VAS,ODI was analyzed. Results：The ratio of supporting phase of observation group was significantly higher than that of control group at 12 days after operation（P〈0.05）. The VAS and ODI in observation group were significantly lower than that of control group at 6 months after operation（P〈0.01）. There was no correlation between the ratio of supporting phase and ODI or VAS in two groups（P〈0.05）. Conclusion：Lumbar percutaneous transforaminal endoscopic discectomy combined with exercise rehabilitation during the perioperative period can release or eliminate postoperative residual pain,improve gait balance,enable activities of daily living,and has a positive effect in patients with lumbar spinal stenosis.

关 键 词：腰椎 椎管狭窄 外科手术 微创性 经皮椎间孔镜手术 康复 

分 类 号：R687.3[医药卫生—骨科学]