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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (5): 452-456.doi: 10.3969/j.issn.1000-6621.2021.05.008

• 论著 • 上一篇    下一篇

基于快速康复的系统模式在胸腰椎结核术后伴睡眠质量障碍患者治疗中的效果评价

艾雅娟, 韩旭()   

  1. 100091 北京,解放军总医院第八医学中心骨科
  • 收稿日期:2021-01-02 出版日期:2021-05-10 发布日期:2021-04-30
  • 通信作者: 韩旭 E-mail:hx3092013mzk@163.com

Effect evaluation of rapid rehabilitation based systematic model in patients with sleep disorder after thoracolumbar tuberculosis surgery

AI Ya-juan, HAN Xu()   

  1. Department of Orthopedics, 8th Medical Center, the General Hospital of Chinese People’s Liberation Army, Beijing 100091, China
  • Received:2021-01-02 Online:2021-05-10 Published:2021-04-30
  • Contact: HAN Xu E-mail:hx3092013mzk@163.com

摘要:

目的 评价基于快速康复的系统模式在胸腰椎结核术后伴睡眠质量障碍患者治疗中的效果评价。 方法 回顾性分析解放军总医院第八医学中心脊柱微创外科2016年2月至2019年8月收治的216例胸腰椎结核手术患者。其中,对2016年2月至2017年8月就诊的104例胸腰椎结核手术患者术后进行常规护理;对2017年9月至2019年8月就诊的112例胸腰椎结核患者术后进行快速康复的系统模式。采用系统随机抽签法从常规护理模式和快速康复系统模式中各抽取40例作为对照组和观察组。比较两组患者术后第3天和术后第1周的疼痛程度[采用视觉模拟评分量表(visual analogue scales,VAS)进行评估]、术后第2周睡眠质量程度(采用匹兹堡睡眠质量指数量表进行评估)和躯体活动能力(采用Braden评分量表进行评估),以及术后住院时间。 结果 观察组术后第3天、术后第1周VAS疼痛评分为(4.22±0.81)分和(2.22±0.82)分,均明显低于对照组[分别为(4.98±1.12)分和(2.98±1.12)分],差异均有统计学意义(t值分别为3.477、3.463,P值均<0.001)。观察组术后第2周匹兹堡睡眠质量指数评分为(5.65±2.40)分,明显低于对照组[(6.98±1.12)分],差异有统计学意义(t=3.176,P=0.001)。观察组术后第2周经常步行的患者有28例(70.0%),明显高于对照组的17例(42.5%),差异有统计学意义(χ2=6.146,P=0.013)。观察组术后住院时间为(14.76±0.86)d,明显短于对照组[(15.22±0.54)d],差异有统计学意义(t=2.865,P=0.002)。 结论 基于快速康复的系统模式在胸腰椎结核术后伴睡眠质量障碍患者的术后治疗中具有明显的效果,可减轻患者疼痛,提高睡眠质量,促使其恢复活动能力。

关键词: 结核,脊柱, 睡眠障碍, 康复护理, 评价研究

Abstract:

Objective Effect evaluation of rapid rehabilitation based system model in patients with sleep disorder after spinal thoracolumbar tuberculosis surgery. Methods This is a retrospective study, 216 patients with thoracolumbar tuberculosis were involved from February 2016 to August 2019 treated in the 8th Medical Center, PLA General Hospital. Among them, 104 patients were treated with routine nursing care after surgery from February 2016 to August 2017, 112 patients were treated with rapid rehabilitation based systematic nursing model after surgery from September 2017 to August 2019. Forty cases were randomly selected from the two models respectively. The differences between the two groups were compared in the pain degree (by visual analogue scales, VAS) on the 3rd day and 1st week after surgery, the sleep quality (by pittsburgh sleep quality index scale) and the physical activity ability (by Braden rating scale) on the 2nd week after surgery, and the postoperative hospital stay. Results The degree of pain in the observation group after postoperative were (4.22±0.81) and (2.22±0.82) on the 3rd day and 1st week respectively, which were lower than the control group (4.98±1.12) and (2.98±1.12), the differences were statistically significant (t=3.477 and 3.463, P<0.001). The degree of Pittsburgh sleep quality index at the second week after operation in the observation group was (5.65±2.40), which was significantly lower than the control group (6.98±1.12), the differences were statistically significant (t=3.176, P=0.001). 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%, 17/40), the difference was statistically significant (χ2=6.146,P=0.013).In the observation group, the postoperative hospitalization time was (14.76±0.86) days, which was less than the control group ((15.22±0.54) days), the difference was statistically significant (t=2.865, P=0.002). Conclusion The systematic nursing model based on rapid rehabilitation has a significant clinical effect in patients with sleep disorder after thoracolumbar tuberculosis surgery, which can reduce pain, improve sleep quality, and promote the recovery of activity.

Key words: Tuberculosis,spinal, Sleep disorders, Rehabilitation nursing, Evaluation studies