全程式健康教育处方对盘源性腰痛患者血清前列腺素E2水平及间盘结构的影响  

作　　者：张利萍[1] 游婷婷[1] 周颖[1] 罗小霞 吴小宝[1] 

机构地区：[1]中国人民解放军第九二医院骨伤科,福建南平353000

出　　处：《中国药业》2017年第A01期138-141,共4页China Pharmaceuticals

基　　金：2016年福建中医药大学校管科研课题[XB2016065]。

摘　　要：目的观察全程式健康教育处方在盘源性腰痛中的应用及对血清前列腺素E2水平及间盘结构的影响。方法选取医院2015年5月至2016年7月收治的盘源性腰痛患者80例,采用随机数字表法分为对照组和观察组,各40组。对照组患者采用常规方法护理,观察组患者在对照组基础上联合全程式健康教育处方护理。采用双抗体夹心酶联免疫吸附试验检测两组患者护理前、后血清前列腺素E2水平;护理前、后采用MRI检查,术中取病变椎体标本进行HE染色,比较两组护理效果及对血清前列腺素E2水平及间盘结构的影响。结果两组护理前VAS评分比较,差异无统计学意义(P>0.05),观察组护理后1,3,5周VAS评分低于对照组(P<0.05);两组护理前ODI评分、HAMA量表评分及前列腺素E2水平比较,差异无统计学意义(P>0.05),观察组护理后ODI评分、HAMA量表评分及前列腺素E2水平低于对照组(P<0.05);MRI检查结果显示,观察组护理后病变的间盘存在轻微的T2WI信号改变,髓核组织氢原子比例下降,含水量下降,且得到了有效控制。对照组护理后MRI下T2WI出现低信号,间隙变窄,软骨终板受损、髓核发生脱水;观察组HE染色结果显示,患者护理后间盘失去正常同心圆结构,胶原纤维成分层级成角度排列,胶原纤维量较少且有蛋白沉积现象;对照组髓核细胞数量较少,存在异常的纤维组织。结论盘源性腰痛患者治疗过程中在常规护理基础上联合全程式健康教育处方护理效果理想,能降低血清前列腺素E2水平,利于间盘结构的恢复,值得临床推广。Objective To observe the application of whole-course health education prescription in patients with discogenic low back pain and its influence on serum prostaglandin E2 level and disc structure.Methods Eighty patients with discogenic low back pain admitted from May 2015 to July 2016 were divided into control group(n=40)and observation group(n=40)by random number method.The patients in the control group were treated with conventional methods,and the observation group was combined with the whole course health education prescription nursing care.The serum prostaglandin E2 levels before and after the two groups were detected by enzyme-linked immunosorbent assay(ELISA).Before and after nursing,The magnetic resonance imaging(MRI)examination was performed to evaluate the effect of the two groups on the prostaglandin E2 level and the structure of the intervertebral disc.Results There was no significant difference in VAS scores between the two groups before nursing(P>0.05).The VAS scores in the observation group were lower than those in the control group at 1 week,3 weeks and 5 weeks after treatment(P<0.05).The scores of ODI,HAMA and prostaglandin E2 in the observation group were significantly lower than those in the control group(P<0.05).MRI findings showed that there was slight T2WI signal change in the intervertebral discs in the observation group,the ratio of the hydrogen atoms in the nucleus pulposus tissue decreased,the water content decreased,and the effective control was achieved.In the control group,T2WI showed low signal,narrowed space,cartilage endplate was damaged and nucleus pulposus was dehydrated.The results of HE staining in the observation group showed that the discs lost the normal concentric structure and the collagen fiber composition angle The number of collagen nucleus cells in the control group was small,and there were abnormal fibrous tissue.Conclusion In the course of the treatment of discogenic low back pain,the combination of routine nursing education and the whole course of health education pre

关 键 词：盘源性腰痛 常规护理 全程式健康教育处方 前列腺素E2 间盘结构 

分 类 号：R472[医药卫生—护理学]