双主体三步法对椎管内肿瘤患者术后康复效果的前瞻性研究  

Prospective study on effect of dual-subjectthree-step method on postoperative recovery inpatients with intradural tumors

作　　者：吕书霞 彭光玲 LYU Shuxia;PENG Guangling(Neurosurgery Department,Yancheng Third People′s Hospital of Jiangsu Province,Yancheng,Jiangsu,224008)

机构地区：[1]江苏省盐城市第三人民医院神经外科,江苏盐城224008

出　　处：《实用临床医药杂志》2025年第1期102-106,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省优势学科建设工程项目(YSHL0174-019)。

摘　　要：目的 探讨双主体三步法在椎管内肿瘤患者围术期的应用效果。方法 选取椎管内肿瘤患者86例行前瞻性研究,随机分为对照组和观察组,每组43例,对照组围术期行常规护理,观察组行双主体三步法干预。观察2组康复进程、围术期不同时点心理状态[患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)]、日本骨科协会腰椎功能(JOA)评分及并发症发生情况。结果 观察组首次排气、首次下床活动、恢复排便及住院时间均短于对照组,差异有统计学意义(P<0.05);术前1 d、术后1 d、出院1个月后,观察组PHQ-9、GAD-7评分均低于对照组,差异有统计学意义(P<0.05);出院时、出院1个月后、随访6个月时,观察组JOA评分均高于对照组,观察组并发症发生率为6.98%,低于对照组的25.58%,差异均有统计学意义(P<0.05)。结论 双主体三步法应用于椎管内肿瘤患者能有效改善身心应激状态,减少并发症,改善腰椎功能,促进术后早期康复。Objective To investigate the effects of the dual-subject three-step method on perioperative outcomes in patients with intradural tumors.Methods A total of 86 patients with intradural tumors were enrolled in a prospective study and were randomly divided into control group and observation group,with 43 patients per group.The control group received routine perioperative care,while the observation group underwent intervention of the dual-subject three-step method.The recovery process,psychological state[Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7(GAD-7)]at different perioperative time points,lumbar spine function scores of Japanese Orthopaedic Association(JOA),and occurrence of complication were observed.Results The observation group exhibited shorter durations for first flatus,first ambulation,recovery of bowel movements,and hospital stay compared with the control group(P<0.05).The PHQ-9 and GAD-7 scores in the observation group were lower than those in the control group at 1 day preoperatively,1 day postoperatively,and 1 month after discharge(P<0.05).At discharge,1 month after discharge,and 6 months during follow-up,the JOA scores in the observation group were higher than those in the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(6.98%versus 25.58%,P<0.05).Conclusion Application of the dual-subject three-step method in patients with intradural tumors can effectively improve psychophysical stress,reduce complications,improve lumbar spine function,and promote early postoperative recovery.

关 键 词：双主体 三步法 椎管内肿瘤 身心应激 腰椎功能 

分 类 号：R739.4[医药卫生—肿瘤] R473.73[医药卫生—临床医学] R473.6