Abstract:

A total of 128 patients undergoing spinal tuberculosis surgery admitted to the Department of Orthopedics, 8th Medical Center, PLA General Hospital, from February 2019 to December 2021 were selected. Routine nursing was performed in 68 cases of the above patients from February 2019 to May 2020, of the other 60 patients admitted from June 2020 to December 2021 were treated with rapid rehabilitation mode based on 4R crisis management after surgery. By random drawing, 40 patients were selected from the each of the two groups as control group and observation group. No emergencies or postoperative complications were found in observation group; while in the control group, 4 cases (10.0%) suffered adverse events and 6 cases (15.0%) had complications, the differences was statistically significant (χ²=4.211, P=0.040; χ²=6.486, P=0.001). The cognitive impairment scores on the third day, the first week and the second week after operation of the observation group were significantly lower than those of the control group (26.90±0.58 vs. 27.12±0.60, t=1.702, P=0.047; 26.72±0.55 vs. 27.02±0.57, t=2.441, P=0.008; 26.57±0.54 vs. 26.95±0.50, t=3.221, P<0.001, respectively). Twenty-nine patients (72.5%) had the independent walking physical activity of independent walking ability after surgery in the observation group, significantly more than that in the control group (19 patients, 47.5%)(Z=-2.467, P=0.014). In the observation group, the postoperative hospitalization time was (14.55±0.67) d, significantly shorter than that in the control group ((15.02±0.82) d, t=2.836, P=0.003). Therefore, for the elderly patients with cognitive impairment after spinal tuberculosis surgery, the implementation of 4R crisis management rapid rehabilitation mode could improve the safety of clinical nursing, reduce the occurrence of postoperative complications, and is helpful to the postoperative rehabilitation of patients.

Key words: Tuberculosis, spinal, Cognition disorders, Rehabilitation, Nursing evaluation research