腰椎后路内固定术医护一体化快速康复的早期结果△

Early outcomes of doctor- nurse cooperated enhanced recovery after surgery for posterior lumbar instrumented fusion

摘要:

［目的］ 探讨腰椎后路内固定术医护一体化快速康复的早期效果。［方法］ 2021 年 1 月—2021 年 6 月，60 例腰椎后路内固定术按随机数字表法分为两组。其中，30 采用常规围术期康复，30 例采用基于医护一体化快速康复。比较两组术前与术后 1 周的临床与心理评估资料。［结果］ 快速组下地行走时间显著早于常规组 （P<0.0001）。与术前相比术后 1 周两组患者 VAS 评分和 ODI 评分显著下降（P<0.05），而 JOA 评分显著增加（P<0.05）。术后 1 周快速组的 ODI 和 JOA 评分显著优于常规组 （P<0.05），但两组间 VAS 评分的差异仍无统计学意义 （P>0.05）。与术前相比，术后 1 周两组 SDS 和 SAS 评分均显著下降（P<0.05）。术后 1 周，快速组 SDS 和 SAS 评分均显著优于常规组（P<0.05）。［结论］ 基于医护一体化快速康复能够帮助腰椎后路内固定术的患者在围术期加快腰椎功能的恢复，有效缓解焦虑、抑郁情绪。

Abstract:

[Objective] To investigate the early outcomes of doctor-nurse cooperated enhanced recovery after surgery (ERAS) for poste- rior lumbar instrumented fusion (PLIF) . [Methods] From January 2021 to June 2021, a total of 60 patients who underwent PLIF for degen- erative lumbar diseases were divided into two groups by random number table method. Of them, 30 patients received routine perioperative rehabilitation (the routine group) , while the other 30 patients received doctor-nurser cooperated ERAS. The clinical and psychological as- sessment data of the two groups were compared before and 1 week after operation. [Results] The ERAS group resumed walking significant- ly earlier than the routine group (P＜0.05) . The VAS and ODI scores significantly decreased, whereas JOA score significantly increased at 1 week after operation compared with those preoperatively in both groups (P＜0.05) . One week after surgery, the ODI and JOA scores in the ERAS group were significantly better than those in the routine group (P＜0.05) , but there was no significant difference in VAS scores be- tween the two groups (P＞0.05) . Both SDS and SAS scores significantly decreased 1 week after surgery compared with those before opera- tion in the two groups (P＜0.05) . One week after operation, the ERAS group proved significantly superior to the routine group in terms of SDS and SAS scores (P＜0.05) . [Conclusion] The doctor-nurse cooperated enhanced recovery after surgery does accelerate the recovery of lumbar function, and effectively relieve anxiety and depression in the perioperative period of posterior lumbar instrumented fusion.