非语言交流联合ERAS阶段性康复护理在腰椎间盘突出症PTED中的应用  

Application of Nonverbal Communication Combined with ERAS Staged Rehabilitation Nursing during PTED for Lumbar Disc Herniation

作　　者：苏艳君 王克荣 顾慧 SU Yanjun;WANG Kerong;GU Hui(Health Management(Prevention and Treatment)Center,Jingdezhen Hospital of Traditional Chinese Medicine,Jingdezhen 333000,China)

机构地区：[1]景德镇市中医医院健康管理(治未病)中心,江西景德镇333000 [2]景德镇市中医医院骨三科,江西景德镇333000

出　　处：《中国医学创新》2024年第24期106-110,共5页Medical Innovation of China

摘　　要：目的:探讨非语言交流联合加速康复外科(ERAS)阶段性康复护理对腰椎间盘突出症经皮椎间孔镜下髓核摘除术(PTED)患者的效果。方法:选取2022年1月—2023年6月景德镇市中医医院收治的80例老年腰椎间盘突出症且接受PTED的患者,参照随机数字表法分为干预组和常规组,各40例。常规组予以围手术期常规护理方案,干预组予以非语言交流联合ERAS理论指导的阶段性康复护理方案。观察两组围手术期指标(手术时间、排气时间、离床活动时间、住院时间);对比两组术后即刻、术后12、24 h视觉模拟评分法(VAS)评分;比较两组干预前后自我效能[一般自我效能感量表(GSES)、慢性疼痛自我效能感量表(CPSS)],末次随访期间的疗效优良率[改良日本骨科协会(M-JOA)腰痛评分]及围手术期并发症。结果:干预组排气时间、离床活动时间、住院时间均短于常规组,差异均有统计学意义(P<0.05),两组手术时间比较,差异无统计学意义(P>0.05)。术后24 h,两组疼痛程度评分均降低,且干预组评分低于常规组,差异均有统计学意义(P<0.05)。干预后,两组GSES、CPSS中疼痛管理、躯体功能及症状应对评分均升高,且干预组评分均高于常规组,差异均有统计学意义(P<0.05)。末次随访时,干预组疗效优良率与常规组比较,差异无统计学意义(P>0.05)。干预组围手术期并发症总发生率与常规组比较,差异无统计学意义(P>0.05)。结论:针对老年腰椎间盘突出症PTED围手术期护理,采用非语言交流联合ERAS理论指导的阶段性康复护理方案可促进患者康复进程加快,缓解术后疼痛,提高患者自我效能,促进腰椎功能恢复正常,且减少并发症发生。Objective:To explore the effect of nonverbal communication combined with enhanced recovery after surgery(ERAS)staged rehabilitation nursing on patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy(PTED).Method:A total of 80 elderly patients with lumbar disc herniation who received PTED in Jingdezhen Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were selected and divided into intervention group and conventional group according to the random number table method,with 40 cases in each group.The conventional group was given perioperative conventional nursing regimen,and the intervention group was given nonverbal communication combined with ERAS theory-guided staged rehabilitation nursing regimen.Perioperative indicators(surgical time,exhaust time,ambulation time,hospital stay)were observed in the two groups;and visual analogue scale(VAS)score at immediately after surgery and at 12 and 24 hours after surgery were compared in the two groups;self-efficacy[general self-efficacy scale(GSES),chronic pain self-efficacy scale(CPSS)]before and after intervention,excellent and good rate of efficacy[modified Japanese Orthopedic Association(M-JOA)back pain score]during the last follow-up and perioperative complications were compared between the two groups.Result:The exhaust time,ambulation time and hospital stay in intervention group were shorter than those in conventional group,the differences were statistically significant(P<0.05),there was no significant difference in surgical time between the two groups(P>0.05).At 24 hours after surgery,the pain degree scores in both groups were decreased,and the score in intervention group was lower than that in conventional group,the differences were statistically significant(P<0.05).After intervention,the GSES score and scores of pain management,physical function and symptom coping of CPSS were increased in both groups,and the scores in intervention group were higher than those in conventional group,the differences were

关 键 词：围手术期 非语言交流 加速康复外科理论 阶段性康复护理 老年腰椎间盘突出症 经皮椎间孔镜下髓核摘除术 自我效能感 

分 类 号：R473.6[医药卫生—护理学]