预康复在颈椎后路手术患者中的应用效果  

Application of pre-rehabilitation in patients undergoing posterior cervical surgery

作　　者：李晓[1] 马晶晶 林怡[1] 胡冠琼[1] 洪素仪 王宇[1] LI Xiao;MA Jingjing;LIN Yi;HU Guanqiong;HONG Suyi;WANG Yu(Department of Orthopedics,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第一医院骨科,浙江温州325015 [2]温州医科大学附属第一医院心血管内科,浙江温州325015

出　　处：《温州医科大学学报》2025年第3期230-236,共7页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(Y20210407)。

摘　　要：目的:研究预康复措施在颈椎后路手术患者中的应用效果。方法:整群抽样纳入2022年2月至2023年4月温州医科大学附属第一医院脊柱外科两个病区收治的行颈椎后路手术的患者。一病区患者作为对照组(57例),二病区患者作为预康复组(64例)。对照组患者接受常规加速康复外科(ERAS)围术期护理,预康复组在常规ERAS围术期护理的基础上增加预康复干预策略,比较两组患者疾病相关知识掌握程度、术后疼痛、术后下床活动时间、术后并发症发生率、住院时间、住院费用、出院时营养状况及心理状态、非计划再入院率及术后回归正常生活情况等。结果:预康复组患者术后即刻及出院时颈部疼痛评分均显著低于对照组(P<0.05)。预康复组静脉血栓栓塞症(VTE)发生率、术后下床活动时间、两组患者疾病相关知识掌握程度、术后住院时间、住院费用、非计划再入院率及术后回归正常生活情况差异均无统计学意义(P>0.05)。结论:预康复措施可降低颈椎后路手术患者术后颈部疼痛水平,促进患者早期活动,加速患者术后康复。Objective:To study the application effect of pre-rehabilitation measures in patients undergoing posterior cervical spine surgery.Methods:The cluster sample included patients undergoing posterior cervical surgery admitted to two wards of Spinal Surgery in the First Affiliated Hospital of Wenzhou Medical University from February 2022 to April 2023.Patients in ward 1 were selected as the control group(n=57),and patients in ward 2 were selected as the pre-rehabilitation group(n=64).The control group received conventional accelerated rehabilitation surgical perioperative care,while the pre-rehabilitation group received the pre-rehabilitation intervention strategy on the basis of conventional accelerated rehabilitation surgical perioperative care.Patients’knowledge related to the disease,postoperative pain,postoperative activities,postoperative complications,length of stay,hospitalization costs,nutritional status and psychological state at discharge,unplanned re-admission rate and postoperative return to normal life were compared between the two groups.Results:The neck pain scores of patients in the pre-rehabilitation group were significantly lower than those in the control group in the immediate postoperative period and at the time of discharge(P<0.05).There were no significant differences between the two groups in terms of the incidence of venous thrombus embolism(VTE),the time of postoperative out-of-bed activities,the degree of knowledge about the disease,the postoperative hospital stay,the hospitalization cost,the rate of unplanned readmission and the time to return to normal life after surgery.Conclusion:Pre-rehabilitation measures can reduce the level of postoperative neck pain in patients who undergo posterior cervical spine surgery,promote patients'early activities,and accelerate patients’postoperative recovery.

关 键 词：预康复 脊髓型颈椎病 颈髓损伤 颈椎后路手术 临床护理 

分 类 号：R681.5[医药卫生—骨科学] R473.6[医药卫生—外科学]