CAJ | 학술논문

目的探讨康复锻炼计划在腰椎间盘突出症手术患者中的应用效果.方法制定腰椎间盘突出症手术患者康复锻炼计划,将70例行腰椎间盘突出症开窗或半椎板切除髓核摘除术的患者随机分为观察组35例和对照组35例,观察组应用腰椎间盘突出症手术患者康复锻炼计划进行干预,对照组给予书面康复锻炼方法及术后注意事项等资料,指导患者自我锻炼.采用中华骨科学会脊柱学组腰背痛手术评定标准判断两组患者临床疗效的优良率；应用健康状况调查问卷(SF-36)评价并比较分析两组患者术前及术后1年健康相关生存质量.结果本研究70例患者中,61例患者完成了1年的随访,其中观察组31例,对照组30例.失访9例,失访率为12.8％.观察组疗效优良率93.5％,对照组73.3％,两组比较差异有统计学意义(x2 =4.063,P＜0.05)；术前两组患者SF-36各维度评分比较差异无统计学意义(P＞0.05)；术后1年观察组SF-36各维度评分分别为,生理功能(55.4±11.2)分,生理职能(49.6±7.5)分,躯体疼痛(78.1±10.5)分,总体健康(67.5±14.5)分,活力(72.3±12.2)分,社会功能(77.0±18.1)分,情感职能(68.6±23.2)分,精神健康(78.9±10.3)分,均高于对照组,差异均有统计学意义(t值分别为2.643,4.321,3.012,2.102,2.412,2.210,2.120,2.321；P＜0.05).结论腰椎间盘突出症手术患者实施康复锻炼计划,能达到提高患者临床疗效和显著改善术后生存质量的目的,值得临床推广应用.
목적 탐토강복단련계화재요추간반돌출증수술환자중적응용효과.방법 제정요추간반돌출증수술환자강복단련계화,장70례행요추간반돌출증개창혹반추판절제수핵적제술적환자수궤분위관찰조35례화대조조35례,관찰조응용요추간반돌출증수술환자강복단련계화진행간예,대조조급여서면강복단련방법급술후주의사항등자료,지도환자자아단련.채용중화골과학회척주학조요배통수술평정표준판단량조환자림상료효적우량솔；응용건강상황조사문권(SF-36)평개병비교분석량조환자술전급술후1년건강상관생존질량.결과 본연구70례환자중,61례환자완성료1년적수방,기중관찰조31례,대조조30례.실방9례,실방솔위12.8％.관찰조료효우량솔93.5％,대조조73.3％,량조비교차이유통계학의의(x2 =4.063,P＜0.05)；술전량조환자SF-36각유도평분비교차이무통계학의의(P＞0.05)；술후1년관찰조SF-36각유도평분분별위,생리공능(55.4±11.2)분,생리직능(49.6±7.5)분,구체동통(78.1±10.5)분,총체건강(67.5±14.5)분,활력(72.3±12.2)분,사회공능(77.0±18.1)분,정감직능(68.6±23.2)분,정신건강(78.9±10.3)분,균고우대조조,차이균유통계학의의(t치분별위2.643,4.321,3.012,2.102,2.412,2.210,2.120,2.321；P＜0.05).결론 요추간반돌출증수술환자실시강복단련계화,능체도제고환자림상료효화현저개선술후생존질량적목적,치득림상추엄응용.
Objective To discuss the effect of rehabilitation exercise program on surgical patients with prolapse of lumbar intervertebral disc.Methods Rehabilitation exercise program was formulated.70 patients with prolapse of lumbar intervertebral disc who had enestration operation or hemilaminectomy discectomy were randomly divided into the observation group and the control group,each with 35 cases.The observation group had rehabilitation exercise program for intervention,while the control group only received materials including written rehabilitation exercise methods and postoperative announcements to guide self-exercise.Chinese Medical Association of Orthopaedics was used to evaluate the excellent rate of clinical effect,and SF-36 was used to compare patients' health related quality of life before and one year after the surgery.Results 61 out of 70 patients finished the follow-up for a year,in which 31 were the observation group and 30 were the control group.9 cases lost contact,with the rate of 12.8％.The excellent rate of curative effect was 93.5％ in the observation group and 73.3％ in the control group,and the difference was statistically significant (x2 =4.063,P ＜0.05).There was no statistically significant difference in SF-36 scores before surgery (P ＞ 0.05).But one year after the surgery,the score of physiological function,psychological function,body pain,overall health,vitality,social function,emotional function and mental health in SF-36 was respectively (55.4 ± 11.2),(49.6 ± 7.5),(78.1±10.5),(67.5±14.5),(72.3±12.2),(77.0±18.1),(68.6±23.2) and (78.9±10.3) in the observation group,all of which were higher than those in the control group,and the differences were statistically significant (t =2.643,4.321,3.012,2.102,2.412,2.210,2.120,2.321,respectively; P ＜ 0.05).Conclusions Rehabilitation exercise program for surgical patients with prolapse of lumbar intervertebral disc can help improve their clinical effect and postoperative quality of life obviously,which is worthy of clinic application.