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

doi:10.3969/j.issn.1000-6621.2021.05.008

Abstract

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

AI Ya-juan, HAN Xu. Effect evaluation of rapid rehabilitation based systematic model in patients with sleep disorder after thoracolumbar tuberculosis surgery[J]. Chinese Journal of Antituberculosis, 2021, 43(5): 452-456. doi: 10.3969/j.issn.1000-6621.2021.05.008

Figures/Tables 3

临床资料	对照组(40例)	观察组(40例)	统计检验值	P值
年龄(岁, $x ˉ$ ±s)	42.35±3.48	42.72±3.11	t=0.501	0.308
性别[例,构成比(%)]			χ²=0.082	0.775
男	8(20.0)	7(17.5)
女	32(80.0)	33(82.5)
文化程度[例,构成比(%)]			χ²=0.764	0.858
小学	1(2.5)	2(5.0)
初中	10(25.0)	8(20.0)
高中	19(47.5)	18(45.0)
大学及以上	10(25.0)	12(30.0)
婚姻状况[例,构成比(%)]			χ²=0.251	0.617
已婚	28(70.0)	30(75.0)
未婚	12(30.0)	10(25.0)
病程(年, $x ˉ$ ±s)	2.38±0.48	2.42±0.52	t=0.357	0.363
患病部位[例,构成比(%)]			χ²=0.802	0.370
胸椎	21(52.5)	17(42.5)
腰椎	19(47.5)	23(57.5)
病灶节段[例,构成比(%)]^a			χ²=0.053	0.818
1个	24(60.0)	25(62.5)
2个	16(40.0)	15(37.5)
术中出血量(ml, $x ˉ$ ±s)	582.75±122.39	598.00±110.06	t=0.590	0.280
手术时间(min, $x ˉ$ ±s)	320.12±61.54	335.05±56.31	t=1.132	0.130
术前血红蛋白 (g/L, $x ˉ$ ±s)	115.29±5.61	116.11±5.14	t=0.682	0.248

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组别	例数	躯体活动能力
组别	例数	卧床	坐椅子	偶尔步行	经常步行
观察组	40	0(0.0)	1(2.5)	11(27.5)	28(70.0)
对照组	40	0(0.0)	3(7.5)	20(50.0)	17(42.5)
χ²值		-	1.053	4.266	6.146
P值		-	0.305	0.039	0.013