阶梯式康复训练在腰椎间盘突出症术后患者中的应用

摘要/Abstract

摘要： 目的探讨在腰椎间盘突出症（LDH）术后患者中应用阶梯式康复训练的效果。方法选取2023年4月—2024年7月在山东省济南市第三人民医院行手术治疗的101例LDH患者,以随机数表法分成干预组（n=51）与对照组（n=50）,对照组给予常规康复训练,干预组给予阶梯式康复训练,两组均干预1个月。比较两组腰椎功能、疼痛程度、生活质量。结果干预前,两组日本骨科协会评估治疗分数（JOA）评分比较,差异无统计学意义（P>0.05）;干预后,两组JOA评分均高于干预前,且干预组高于对照组,差异有统计学意义（P<0.05）。干预前,两组VAS评分比较,差异无统计学意义（P>0.05）;干预后,两组视觉模拟评分法（VAS）评分均低于干预前,且干预组低于对照组,差异有统计学意义（P<0.05）。干预前,两组世界卫生组织生活质量量表（WHOQOL-100）各维度评分比较,差异无统计学意义（P>0.05）;干预后,两组WHOQOL-100各维度评分均高于干预前,且干预组高于对照组,差异有统计学意义（P<0.05）。结论阶梯式康复训练应用于LDH术后患者干预中,可改善腰椎功能,减轻疼痛感,提高生活质量。

关键词: 腰椎间盘突出症, 手术, 阶梯式康复训练, 腰椎功能

Abstract: Objective To investigate the effect of step rehabilitation training in patients with lumbar disc herniation (LDH) after operation. Methods A total of 101 LDH patients who underwent surgical treatment in Jinan Third People's Hospital from April 2023 to July 2024 were selected and divided into intervention group (n=51) and control group (n=50) by random number table method. The control group was given routine rehabilitation training, and the intervention group was given stepped rehabilitation training. Both groups were treated for 1 month. Lumbar function, pain and quality of life were compared between the two groups. Results Before intervention, there was no difference in the Japanese Orthopaedic Association(JOA) between the two groups (P>0.05). After intervention, the JOA scores of both groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Before intervention, there was no difference in VAS scores between the two groups (P>0.05). After intervention, the visual analogue scale (VAS) scores of both groups were lower than before intervention, and the intervention group was lower than control group, the difference was statistically significant (P<0.05). Before intervention, there was no difference in the scores of World Health Organization Quality of Life -100(WHOQOL-100) between the two groups (P>0.05). After intervention, the WHOQOL-100 scores of both groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Conclusion The application of step rehabilitation training in the intervention of LDH patients can improve the function of lumbar spine, relieve pain and improve the quality of life.

Key words: lumbar disc herniation, surgery, step rehabilitation training, lumbar function

中图分类号:

R681.5+3

王芳. 阶梯式康复训练在腰椎间盘突出症术后患者中的应用[J]. 中华养生保健, 2025, 43(7): 5-9.

WANG Fang. Application of Step Rehabilitation Training in Postoperative Patients with Lumbar Disc Herniation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(7): 5-9.

参考文献

[1] 王晓玲,马红娜,谭璐,等.腰腹部核心肌力训练在腰椎间盘突出症术后患者中的应用[J].齐鲁护理杂志,2024,30(12):161-163.
[2] 邱霞,周晓吉,景慧云,等.腰部核心肌力训练联合呼吸训练对LDH患者术后脊柱功能及生活质量的影响[J].河北医药,2023,45(3):361-364.
[3] 周勋琦,李建华,邓乙首,等.核心肌群训练对腰椎间盘突出症患者腰椎功能的影响[J].中华物理医学与康复杂志,2024,46(8):731-733.
[4] 叶必宏,叶绿,毛显禹,等.温针灸联合康复训练对腰椎间盘突出症经皮椎间孔镜下髓核摘除术后恢复进程的影响观察[J].中华中医药学刊,2022,40(3):212-215.
[5] 刘小平,吴丹丹,樊露涛,等.阶梯式康复训练联合反复促通技术对脑中风后偏瘫患者的影响[J].中国疗养医学,2024,33(10):41-44.
[6] 薛凤卿,李民,张陆.阶梯式康复训练在胫骨平台骨折术后康复中的应用效果分析[J].中国烧伤创疡杂志,2023,35(2):154-157.
[7] 祝明秋,朱达惠,代群莉.阶梯式康复训练对腰椎间盘突出症患者腰椎功能及术后疼痛的影响[J].临床护理研究,2023,32(1):45-46,52.
[8] 中国康复医学会脊柱脊髓专业委员会基础研究与转化学组.腰椎间盘突出症诊治与康复管理指南[J].中华外科杂志,2022,60(5):401-408.
[9] 孙兵,车晓明.日本骨科协会评估治疗(JOA评分)[J].中华神经外科杂志,2012,28(6):623-623.
[10] JENSEN M P, KAROLY P, BRAVER S.The measurement of clinical pain intensity: a comparison of six methods[J].Pain,1986,27(1):117-126.
[11] 方积乾,郝元涛,李彩霞.世界卫生组织生活质量量表中文版的信度与效度[J].中国心理卫生杂志,1999,13(4):203-205.
[12] 高健,李伟.腰椎运动链训练系统对腰椎间盘突出症患者术后腰椎功能与生物力学的影响[J].应用力学学报,2024,41(2):477-484.
[13] 周亚薇. 持续被动活动机联合康复训练对腰椎间盘突出患者术后腰椎功能的影响[J].吉林医学,2023,44(9):2653-2655.
[14] 王园,白敏.腰部核心肌力训练对老年腰椎间盘突出症患者术后腰椎功能及血清疼痛物质的影响[J].贵州医药,2024,48(9):1488-1489.
[15] 韦明敏,曹玮.系统康复训练在腰椎间盘突出症患者术后离床训练中的应用[J].当代护士(下旬刊),2022,29(6):104-107.
[16] 康瑜. 阶梯式运动康复训练对慢性心力衰竭患者自我护理能力及生活质量的影响[J].中国临床护理,2024,16(1):19-22.
[17] 黄勇,王丽.渐进式康复训练模式在中老年腰椎间盘突出症患者中的应用价值分析[J].颈腰痛杂志,2022,43(5):657-659.
[18] 赵书会,范帆,李彤.阶梯式康复训练结合音乐疗法在腰椎间盘突出症术后患者中的应用[J].中华现代护理杂志,2023,29(23):3194-3198.
[19] 曾锴,苏小玲.补气化瘀通络方联合量化康复训练对脑卒中后肩手综合征患者上肢运动功能及血液流变学的影响[J].中国基层医药,2022,29(10):1461-1465.
[20] 石智晔. Sarcopenia的骨骼肌卫星细胞功能及可能机制[C]//第四届(2016)全国运动生理与生物化学学术会议论文集,2016:436.
[21] 缪友云,高娟,彭小强,等.时机性康复训练联合渐进肌肉放松训练在腰椎间盘突出症患者术后康复中的应用[J].齐鲁护理杂志,2022,28(20):114-116.
[22] 范先凤,郭玉红.在微创腰椎间盘突出术后采用阶梯式康复护理应用效果评价[J].饮食保健,2020,7(28):209.
[23] 刘采群,唐成剑,周长征,等.腹式呼吸训练联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、肺功能及腰部姿势控制能力的影响[J].现代生物医学进展,2024,24(1):101-105.
[24] 曹晶晶,梅展展,王文雅,等.专项康复训练对腰椎间盘突出症康复期患者康复效果的影响[J].河南医学研究,2024,33(1):128-132.
[25] 余小冬,林小永,王慈香.阶梯式康复训练对胫骨平台骨折患者术后膝关节功能的影响[J].延安大学学报(医学科学版),2021,19(1):104-107.
[26] 徐燕,金旭霞,强发莲.阶梯式康复训练在老年髋部骨折术后应用效果[J].浙江创伤外科,2024,29(5):942-944.