关键词: 老年人, 结核, 脊柱, 手术后医护, 康复, 移乘训练

Abstract:

Objective To explore the efficacy of early transfer training (bed-wheelchair) in the rehabilitation of elderly patients with spinal tuberculosis after focal removal and bone graft fixation.Methods Patients with spinal tuberculosis who were admitted to the Spinal Minimally Invasive Department of the Orthopaedic Center of the 309th Hospital of Chinese People’s Liberation Army from February 2015 to March 2018, aged from 60 to 70 years, and were treated by removing lesions and bone grafting and fixation were selected. A total of 80 patients were included in this study. Forty patients who were admitted to hospital from February 2015 to August 2016 were allocated in the control group, and 40 patients admitted from September 2016 to March 2018 were allocated in the observation group. In the control group, the patients received routine bed functional exercise after the debridement and bone graft fixation, and received weight-bearing standing training on the 16th day after the surgery by wearing a brace. In the observation group, on the basis of the control group’s routine bed functional exercise, the patients underwent transfer training (bedside-wheelchair) with the help of doctors and family members on the 3rd day after the surgery when the patient’s vital signs were good. Serum albumin, hemoglobin, body mass index (BMI), physical activity and postoperative hospital stay were compared between the two groups.Results In the observation group, the serum albumin, hemoglobin and BMI of the senile patients with spinal tuberculosis were ((39.51±3.51)g/L, (122.11±10.14)g/L, and 20.16±2.84, respectively), which were superior to those in the control group ((36.33±3.43)g/L, (115.29±12.61)g/L, and 18.57±2.76, respectively). The differences were statistically significant (t values were 4.10, 2.67, and 2.54; P values were 0.000, 0.009, and 0.013, respectively). There were 28 patients (70.0%) who were able to walk frequently two weeks after surgery in the observation group. The proportion was higher than that in the control group (42.5%, n=17). The difference was statistically significant (χ²=6.15, P=0.013). The postoperative hospital stay in the observation group was (17.3±2.0) days, which was significantly less than that in the control group (18.6±0.8) days. The difference was statistically significant (t=3.82, P=0.000).Conclusion Early transfer training (bed-wheelchair) promotes rehabilitation, reduces the length of hospital stay, and reduces costs.

Key words: Aged, Tuberculosis, spinal, Postoperative care, Rehabilitation, Transfer training