共享决策下康复训练方案对低粘度骨水泥椎体成形术治疗骨质疏松椎体压缩性骨折术后康复效果的影响  

Influence of Rehabilitation Training Regimen under Shared Decision-making on Postoperative Rehabilitation Effect of Osteoporotic Vertebral Compression Fractures Treated by Low Viscosity bone Cement Vertebroplasty

作　　者：肖丹 XIAO Dan(Department of orthopedics,affiliated hospital of Jinggangshan university,Jian,Jiangxi Province 343000)

机构地区：[1]井冈山大学附属医院骨科,江西吉安343000

出　　处：《中国伤残医学》2023年第9期23-28,共6页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨骨质疏松椎体压缩性骨折患者行低粘度骨水泥椎体成形术后执行共享决策下康复训练方案对康复效果的影响。方法:选取我院2018年1月-2020年1月收治的骨质疏松性椎体压缩性骨折患者62例作为研究对象,将其按照随机对照法分为对照组与观察组,各31例。对照组给予常规康复训练方案治疗,观察组给予共享决策康复训练方案。比较2组患者视觉模拟疼痛评分(VAS)、功能障碍指数(ODI)评分及骨质疏松知识掌握度、生活能力、腰痛程度及骨转化标志物水平等。结果:观察组术后24小时、7天的VAS低于对照组,出院时及术后3个月ODI评分低于对照组,患者对骨质疏松知识的了解情况好于对照组,以上差异均有统计学意义(P<0.05);干预后2组患者反射活动、屈肌共同运动、联合共同运动、分离运动及协调运动评分均有所上升,且观察组优于对照组,比较差异有统计学意义(P<0.05);干预后2组患者Barthel指数及生活质量指数(QLI)评分均有所改善,且观察组优于对照组,比较差异有统计学意义(P<0.05);干预后观察组Fairbank JC“腰痛病情计分表”评分低于对照组,伤椎前缘高度及伤椎前后缘高度比值优于对照组,比较差异有统计学意义(P<0.05);干预后2组伤椎后缘高度比较差异无统计学意义(P>0.05);2组患者骨折后4周骨钙素N端中分子片段(N-MID)、I型前胶原氨基端端肽(P1NP)及骨特异碱性磷酸酶(BSAP)水平比较差异有统计学意义,观察组高于对照组(P<0.05),2组患者骨折后8周BSAP、N-MID、P1NP水平均有所上升,观察组高于对照组,比较差异有统计学意义(P<0.05)。结论:共享决策下的康复训练方案应用于低粘度骨水泥椎体成形术治疗骨质疏松椎体压缩性骨折术后康复训练,可改善患者肢体活动功能,降低疼痛,促进骨折愈合,改善患者预后,值得临床推广。Objective:To explore the influence of rehabilitation training regimen under shared decision-making on the rehabilitation effect of patients with osteoporotic vertebral compression fractures after low viscosity bone cement vertebroplasty.Methods:62 patients with osteoporotic vertebral compression fractures treated in the hospital between January 2018 and January 2020 were selected as the re-search subjects,and they were divided into routine group and observation group according to the randomized control method,with 31 ca-ses in each group.The routine group was given routine rehabilitation training regimen,and the observation group was given shared deci-sion-making rehabilitation training regimen.Visual Analogue Pain Score(VAS),Oswestry Disability Index(ODI)score,mastery of osteoporosis knowledge,living ability,low back pain degree and levels of bone transformation markers were compared between the two groups of patients.Results:The VAS scores at 24 h and 7 d after surgery of observation group were lower than those of routine group,and the ODI scores at discharge and at 3 months after surgery were lower than those of routine group,and the patients,mastery of osteo-porosis knowledge was better than that of routine group(P<0.05).After intervention,the scores of reflex activity,flexor synergy,joint synergy,separation motion and coordinated motion were increased in the two groups,and the scores of observation group were better than those of routine group(P<0.05).After intervention,the scores of Barthel index and quality of life index(QLI)in the two groups of pa-tients were improved,and the scores were better in observation group than those in routine group(P<0.05).The score of Fairbank JC“low back pain scoring scale”after intervention in observation group was lower than that in routine group,and the anterior height of in-jured vertebra and the ratio of anterior and posterior height of injured vertebrae were better than those in routine group(P<0.05).There was no difference in posterior height of injured vertebra be

关 键 词：低粘度骨水泥 骨质疏松椎体压缩性骨折 椎体成形术 共享决策 康复训练 

分 类 号：R493[医药卫生—康复医学]