腰椎间盘突出症患者早期下床活动现状及其影响因素分析  

Analysis of the early ambulation status in patients with lumbar disc herniation and its influencing factors

作　　者：卢思宇 刘彦 廖娜霞[3] 张一格 李小鸽 LU Siyu;LIU Yan;LIAO Naxia;ZHANG Yige;LI Xiaoge(College of Nursing,University of South China,Hengyang421001,China;Hengyang Medical School,University of South China,Hengyang421001,China;Department of Spine Surgery,the First Affiliated Hospital of University of South China,Hengyang421001,China)

机构地区：[1]南华大学护理学院,湖南衡阳421001 [2]南华大学衡阳医学院,湖南衡阳421001 [3]南华大学附属第一医院脊柱外科,湖南衡阳421001

出　　处：《中国现代医生》2022年第9期8-11,15,共5页China Modern Doctor

基　　金：湖南省教育厅科学研究项目(19K077)。

摘　　要：目的探讨腰椎间盘突出症患者早期下床活动现状及其影响因素。方法便利抽取2020年5月至2021年2月某市三级甲等医院符合纳入标准的180例腰椎间盘突出症术后患者为研究对象,对其手术情况、早期下床活动情况、康复自我效能情况进行问卷调查,并进行logistic回归分析。结果180例患者中,62例执行早期纳入下床活动,118例未完成早期下床活动,首次下床活动时间最早为术后6 h,集中在术后第2天;单因素分析显示,两组患者术后留置导尿管、术中手术持续时间、术后24 h疼痛、术后首次排气时间、早期疲乏、早期下床活动意愿、术后总蛋白水平、康复自我效能比较,差异有统计学意义(P<0.05)。logistic回归分析显示,患者术后24 h疼痛评分、早期疲乏、早期意愿、康复自我效能总分对早期下床活动影响较大。结论腰椎间盘突出症术后患者的早期下床活动现状欠佳,护理人员应加强术后疼痛管理、鼓励患者、增强信心,提高患者下床意愿,促进患者早期康复。Objective To investigate the status and influencing factors of early ambulation in patients with lumbar disc herniation.Methods A total of 180 postoperative patients with lumbar disc herniation in a third-level hospital in a city who met the selection criteria from May 2020 to February 2021 were conveniently selected as research objects.A questionnaire survey and logistic regression analysis were conducted on surgical conditions,early ambulation,and rehabilitation self-efficacy.Results Of the 180 patients,62 patients performed early ambulation,118 patients did not complete early ambulation.The earliest time to the first ambulation was 6 hours after surgery,concentrated on the second day after surgery.There were significant differences in the postoperative indwelling catheter,duration of intraoperative surgery,postoperative 24 h pain,postoperative first exhaust time,early fatigue,early ambulation willingness,postoperative total protein level,and rehabilitation self-efficacy between the two groups(P<0.05).logistic regression analysis showed that patients'pain score at 24 hours after surgery,early fatigue,early willingness,and total score of rehabilitation self-efficacy significantly impacted early ambulation.Conclusion The current status of early ambulation in patients after lumbar disc herniation is poor.Nursing staff should strengthen postoperative pain management,encourage patients,enhance confidence,improve patients'ambulation willingness,and promote early recovery of patients.

关 键 词：腰椎间盘突出症 早期下床活动 活动水平 影响因素 

分 类 号：R681.53[医药卫生—骨科学] R395.2[医药卫生—外科学]