快速康复结合时效性激励理论干预在脊柱侧凸手术患者中的应用效果

王瑞玲; 申勇

doi:10.16766/j.cnki.issn.1674-4152.003821

快速康复结合时效性激励理论干预在脊柱侧凸手术患者中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.003821

王瑞玲,
申勇^,

河北医科大学第三医院脊柱一科，河北石家庄 050000

基金项目:

河北省2023年度医学科学研究课题计划项目 20230673

详细信息

通讯作者:
申勇，E-mail：798751432@qq.com

中图分类号: R682.3 R493
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- 文章访问数: 12
- HTML全文浏览量: 12
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-12
- 网络出版日期: 2025-01-20

The application effect of rapid rehabilitation intervention combined with timeliness incentive theory in patients with scoliosis surgery

WANG Ruiling,
SHEN Yong^,

Department of Spine, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China

摘要

摘要: 目的以快速康复、时效性激励理论为指导，对脊柱侧凸手术患者实施相应干预，旨在促进患者术后良好康复。方法选取2022年3月—2023年3月于河北医科大学第三医院进行后路矫形内固定术治疗的脊柱侧凸患者80例，采用随机数表法分为观察组(40例，快速康复结合时效性激励理论干预)和对照组(40例，常规护理)。对所有患者进行至少为期3个月的跟踪随访，对比2组干预前后疼痛、心理状态、腰椎功能以及术后并发症发生情况。结果干预后1、2、3个月, 观察组的视觉疼痛模拟评分法(VAS)评分均低于对照组(P＜0.05)。相较于对照组，观察组干预后和末次随访时抑郁自评量表(SDS)、焦虑自评量表(SAS)、腰痛评分标准(ODI)以及脊柱侧凸研究问卷表(SRS-22)评分较低，Berg平衡量表(BBS)较高(P＜0.05)。观察组术后腰痛总发生率低于对照组[25.00%(10/40) vs. 47.50%(19/40), P＜0.05]。2组术后发热[2.50%(1/40) vs. 10.00%(10/40)]、单侧下肢皮温异常[5.00%(2/40) vs. 15.00%(6/40)]、呼吸道水肿或炎症[0 vs. 2.50%(1/40)]、术后髋关节疼痛[27.50%(11/40) vs. 47.50%(19/40)]比较，差异均无统计学意义(P＞0.05)。结论快速康复结合时效性激励理论干预，可显著减轻脊柱侧凸手术患者术后疼痛感，改善情绪反应，并促进术后康复。
- 快速康复护理 /
- 时效性激励理论 /
- 脊柱侧凸 /
- 疼痛 /
- 心理状态 /
- 术后康复
Abstract: Objective Under the guidance of the theory of rapid recovery and timeliness incentive, the corresponding intervention was carried out on the patients with scoliosis surgery, aiming at promoting the good postoperative recovery of the patients. Methods From March 2022 to March 2023, 80 patients with scoliosis who underwent posterior orthopedic internal fixation enrolled in the Third Hospital of Hebei Medical University were chosen and separated into the observation group (n=40, rapid rehabilitation combined with timeliness incentive theory) and the control group (n=40, routine nursing) by random number table method. All patients were followed up for at least 3 months. Pain, mental state, lumbar function, and postoperative complications were compared between the two groups before and after intervention. Results Visual analogue scale (VAS) scores in the observation group were lower than those in the control group after 1/2/3 months of intervention (P<0.05). Compared with the control group, the self-rating depression scale (SDS)/ self-rating anxiety scale (SAS), Oswestry disability index (ODI), and scoliosis research scale (SRS-22) scores in the observation group were lower after intervention and at the last follow-up, while Berg balance scale (BBS) scores were higher (P<0.05). The total incidence of postoperative low back pain in the observation group was lower [(25.00% (10/40) vs. 47.50% (19/40), P<0.05]. There was no statistically significant difference in the incidences of postoperative fever [2.50% (1/40) vs. 10.00% (10/40)], unilateral lower extremity skin temperature abnormality [5.00% (2/40) vs. 15.00% (6/40)], respiratory edema or inflammation [0 vs. 2.50% (1/40)] and hip pain [27.50% (11/40) vs. 47.50% (19/40)] between the two groups (P>0.05). Conclusion Rapid rehabilitation combined with timeliness incentive theory can significantly reduce the postoperative pain of patients undergoing scoliosis surgery, improve emotional response, and promote postoperative rehabilitation.
- Rapid rehabilitation nursing /
- Timeliness incentive theory /
- Scoliosis /
- Pain /
- Mental state /
- Postoperative rehabilitation

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表 1 2组脊柱侧凸手术患者一般资料比较

Table 1. Comparison of general data between the two groups of patients undergoing scoliosis surgery

组别	例数	性别(例)		脊柱侧突类型(例)		年龄 (x±s，岁)	Cobb(x±s，°)
组别	例数	男性	女性	先天性	推行性	年龄 (x±s，岁)	Cobb(x±s，°)
观察组	40	29	11	20	20	53.03±10.05	56.97±8.15
对照组	40	21	19	27	13	56.89±9.46	54.26±10.96
统计量		3.413^a		2.527^a		1.769^b	1.255^b
P值		0.065		0.112		0.081	0.213
注：^a为χ²值，^b为t值。

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表 2 2组患者干预前后VAS评分对比(x±s，分)

Table 2. Comparison of VAS scores between the two groups of patients before and after intervention (x±s, points)

组别	例数	干预前	干预后1个月	干预后2个月	干预后3个月
观察组	40	6.46±0.62	4.19±0.31^a	3.10±0.77^ab	1.73±0.38^abc
对照组	40	6.72±0.91	5.71±1.46^a	4.74±1.50^ab	2.00±0.75^abc
F值		1.608	6.822	6.377	2.783
P值		0.112	＜0.001	＜0.001	0.007
注：F_交互=13.250，P_交互＜0.001；F_组间=77.918，P_组间＜0.001；F_时间=358.187，P_时间＜0.001。与同组干预前比较，^aP＜0.05；与同组干预后1个月比较，^bP＜0.05;与同组干预后2个月比较，^cP＜0.05。

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表 3 2组患者干预前后心理状态比较(x±s，分)

Table 3. Comparison of psychological states between the two groups of patients before and after intervention (x±s, points)

组别	例数	SDS			SAS
组别	例数	干预前	干预后	末次随访时	干预前	干预后	末次随访时
观察组	40	79.60±7.49	49.63±13.34^a	45.78±7.99^ab	65.47±10.75	51.52±5.63^a	45.29±1.13^ab
对照组	40	75.66±10.85	62.19±6.78^a	50.81±10.96^ab	63.83±9.24	55.24±7.40^a	51.34±2.49^ab
F值		1.937	5.440	2.403	0.750	2.593	13.993
P值		0.056	＜0.001	0.018	0.456	0.011	＜0.001
注：SDS，F_交互=14.082，P_交互＜0.001；F_组间=12.811，P_组间＜0.001；F_时间=191.195，P_时间＜0.001。SAS，F_交互=6.330，P_交互=0.002；F_组间=8.974，P_组间=0.003；F_时间=113.812，P_时间＜0.001。与同组干预前比较，^aP＜0.05；与同组干预后比较，^bP＜0.05。

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表 4 2组患者干预前后BBS、SRS-22和ODI评分比较(x±s，分)

Table 4. Comparison of BBS, SRS-22, and ODI scores between the two groups of patients before and after intervention (x±s, points)

组别	例数	BBS			SRS-22			ODI
组别	例数	干预前	干预后	末次随访时	干预前	干预后	末次随访时	干预前	干预后	末次随访时
观察组	40	45.51±4.12	53.34±6.36^a	54.73±5.14^ab	72.92±10.43	60.92±8.11^a	61.06±5.64^ab	21.31±2.36	9.69±2.14^a	8.15±1.39^ab
对照组	40	46.47±10.57	49.11±9.88^a	51.82±7.38^ab	75.65±8.90	64.23±7.65^a	63.98±7.08^ab	20.92±0.97	11.58±1.03^a	10.27±2.82^ab
F值		0.548	2.333	2.097	1.290	1.924	2.091	0.991	5.157	4.370
P值		0.585	0.022	0.039	0.201	0.058	0.040	0.325	＜0.001	＜0.001
注：BBS, F_交互=2.511，P_交互=0.083；F_组间=4.394，P_组间=0.037；F_时间=19.492，P_时间＜0.001。SRS-22, F_交互=0.031，P_交互=0.974；F_组间=8.152，P_组间=0.005；F_时间=55.921，P_时间＜0.001。ODI, F_交互=10.482，P_交互＜0.001；F_组间=23.792，P_组间＜0.001；F_时间=920.663，P_时间＜0.001。与同组干预前比较，^aP＜0.05；与同组干预后比较，^bP＜0.05。

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表 5 2组患者术后并发症比较[例(%)]

Table 5. Comparison of postoperative complications between the two groups of patients [cases (%)]

组别	例数	术后腰痛	术后髋关节疼痛	单侧下肢皮温异常	呼吸道水肿/炎症	发热
观察组	40	10(25.00)	11(27.50)	2(5.00)	0	1(2.50)
对照组	40	19(47.50)	19(47.50)	6(15.00)	1(2.50)	4(10.00)
χ²值		4.381	3.413	1.250		0.853
P值		0.036	0.065	0.264	0.999^a	0.356
注：^a为采用Fisher精确检验。

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