颈椎病手术患者术前预康复方案的构建  

Development of a prehabilitation program for patients undergoing cervical spondylosis surgery

作　　者：邓旭 周晓玲[1] 孙倩倩 Deng Xu;Zhou Xiaoling;Sun Qianqian(Department of Orthopedics,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院骨科,西安710061

出　　处：《中华现代护理杂志》2025年第11期1457-1463,共7页Chinese Journal of Modern Nursing

摘　　要：目的构建颈椎病手术患者术前预康复方案,完善术前管理内容,为专科临床护理提供指导。方法于2024年3月成立预康复小组,通过文献回顾提取颈椎病术前预康复最佳证据,经过小组讨论初步形成颈椎病术前预康复方案初稿。于2024年4—5月遴选20名专家,进行2轮专家函询后确定方案内容。专家积极程度采用问卷回收率表示,专家权威程度采用专家权威系数表示,采用肯德尔和谐系数和变异系数表示专家意见协调程度。结果2轮专家函询的问卷回收率均为100.00%(20/20),权威系数均为0.93。第1轮函询的变异系数为0.06~0.20,肯德尔和谐系数为0.121(P<0.01);第2轮函询的变异系数为0~0.16,肯德尔和谐系数为0.108(P<0.01)。最终形成的颈椎病术前预康复方案包括运动干预、营养支持、心理干预、疼痛干预和预防血栓5个一级条目、15个二级条目、31个三级条目。结论本研究构建的颈椎病术前预康复方案具有较好的科学性及可行性,可为临床开展颈椎病患者的术前预康复提供理论参考和实践指引。Objective To develop a prehabilitation program for patients undergoing cervical spondylosis surgery,optimize preoperative management,and provide guidance for specialized clinical nursing.Methods In March 2024,a prehabilitation team was established to extract the best available evidence on preoperative rehabilitation for cervical spondylosis through a literature review.After group discussions,an initial draft of the prehabilitation program was developed.Between April and May 2024,20 experts were selected for a two-round Delphi consultation to finalize the program content.Expert engagement was measured by questionnaire response rates,while expert authority was evaluated using an authority coefficient.The degree of consensus among experts was assessed using Kendall's coefficient of concordance and the coefficient of variation.Results The response rate for both rounds of expert consultation was 100.00%(20/20),with an authority coefficient of 0.93.In the first round,the coefficient of variation ranged from 0.06 to 0.20,and Kendall's coefficient of concordance was 0.121(P<0.01).In the second round,the coefficient of variation ranged from 0 to 0.16,and Kendall's coefficient of concordance was 0.108(P<0.01).The final prehabilitation program consisted of five primary categories(exercise intervention,nutrition support,psychological intervention,pain management,and thrombosis prevention),15 secondary categories,and 31 tertiary categories.Conclusions The prehabilitation program developed in this study demonstrates strong scientific validity and feasibility.It provides a theoretical framework and practical guidance for implementing preoperative prehabilitation for patients undergoing cervical spondylosis surgery.

关 键 词：颈椎病 加速康复外科 预康复 术前管理 德尔菲法 方案构建 

分 类 号：R473.6[医药卫生—护理学]