腰椎后路内固定术医护一体化快速康复的早期结果  

Early outcomes of doctor-nurse cooperated enhanced recovery after surgery for posterior lumbar instrumented fusion

作　　者：孙连中 尹会[2] 李云[2] 刘洋[2] 张清[1] SUN Lian-zhong;YIN Hui;LI Yun;LIU Yang;ZHANG Qing(School of Nursing,Tianjin Medical University,Tianjin 300070,China;Department of Orthopedics,General Hospital,Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学护理学院,天津300070 [2]天津医科大学总医院骨科,天津300052

出　　处：《中国矫形外科杂志》2022年第9期846-849,共4页Orthopedic Journal of China

基　　金：国家自然科学基金委员会资助项目(编号:81871766)。

摘　　要：[目的]探讨腰椎后路内固定术医护--体化快速康复的早期效果。[方法]2021年1月一2021年6月,60例腰椎后路内固定术按随机数字表法分为两组。其中,30采用常规围术期康复,30例采用基于医护--体化快速康复。比较两组术前与术后1周的临床与心理评估资料。[结果]快速组下地行走时间显著早于常规组(P<0.0001)。与术前相比术后1周两组患者VAS评分和0DI评分显著下降(P<0.05),而J0A评分显著增加(P<0.05)。术后1周快速组的0DI和J0A评分显著优于常规组(P<0.05),但两组间VAS评分的差异仍无统计学意义(P>0.05)。与术前相比,术后1周两组SDS和SAS评分均显著下降(P<0.05)。术后1周,快速组SDS和SAS评分均显著优于常规组(P<0.05)。[结论]基于医护一体化快速康复能够帮助腰椎后路内固定术的患者在围术期加快腰椎功能的恢复,有效缓解焦虑、抑郁情绪。[Objective]To investigate the early outcomes of doctor-nurse cooperated enhanced recovery after surgery(ERAS)for posterior lumbar instrumented fusion(PLIF).[Methods]From January 2021 to June 2021,a total of 60 patients who underwent PLIF for degenerative lumbar diseases were divided into two groups by random number table method.Of them,30 patients received routine perioperative rehabilitation(the routine group),while the other 30 patients received doctor-nurser cooperated ERAS.The clinical and psychological assessment data of the two groups were compared before and 1 week after operation.[Results]The ERAS group resumed walking significantly earlier than the routine group(P<0.05).The VAS and ODI scores significantly decreased,whereas JO A score significantly increased at 1 week after operation compared with those preoperatively in both groups(P<0.05).One week after surgery,the ODI and JOA scores in the ERAS group were significantly better than those in the routine group(P<0.05),but there was no significant difference in VAS scores between the two groups(P>0.05).Both SDS and SAS scores significantly decreased 1 week after surgery compared with those before operation in the two groups(P<0.05).One week after operation,the ERAS group proved significantly superior to the routine group in terms of SDS and SAS scores(P<0.05).[Conclusion]The doctor-nurse cooperated enhanced recovery after surgery does accelerate the recovery of lumbar function,and effectively relieve anxiety and depression in the perioperative period of posterior lumbar instrumented fusion.

关 键 词：腰椎后路内固定术 医护一体化 快速康复 腰椎功能 心理健康 

分 类 号：R687[医药卫生—骨科学]