摘要
目的探讨个体化康复治疗胸腰椎骨质疏松性骨折合并腰背部软组织损伤的疗效。方法选取2019年10月至2020年8月在宁波市第六医院行经皮椎体后凸成形术(PKP)治疗的胸腰椎骨质疏松性骨折合并腰背部软组织损伤患者52例。27例予常规康复治疗(对照组),25例在常规康复治疗的基础上增加个体化康复治疗(观察组)。术后12~24 h嘱患者主诉其疼痛缓解情况(好转、无变化或更坏),计算疼痛缓解率;采用腰部疼痛的视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)评估患者术后1 d、1个月和3个月时腰部疼痛及功能评分改善情况;术后3个月时复查磁共振评估患者软组织损伤改善情况。计量资料连续性时点的比较采用重复测量方差分析,计数资料的比较采用χ^(2)检验。结果术后12~24 h,观察组疼痛缓解率明显高于对照组(χ^(2)=13.254,P<0.05)。两组患者手术前后不同时点的VAS和ODI的比较均有组间效应(F=10.541、8.387,P<0.05);其中术后1、3个月,观察组患者腰部VAS及ODI评分的改善较对照组更明显(P<0.05)。术后3个月时,观察组好转优良率明显高于对照组(χ^(2)=19.653,P<0.05)。结论个体化康复治疗可以促进胸腰椎骨质疏松性骨折合并腰背部软组织损伤患者的术后早期功能恢复,有效降低患者术后腰痛的发生率。
Objective To explore the effect of individual rehabilitation on thoracolumbar osteoporotic fracture with soft tissue injury in thoracolumbar spine.Methods The clinical data of 52 patients with thoracolumbar osteoporotic fractures with low back soft tissue injury treated by percutaneous kyphoplasty were selected in Ningbo No.6 Hospital from October 2019 to August 2020.The control group(27 cases)received routine rehabilitation treatment,while the observation group(27 cases)added individualized rehabilitation treatment on the basis of routine rehabilitation treatment.Require patients to report their pain relief status(improvement,no change,or worse)12 to 24 hours after surgery,and calculate the pain relief rate.The visual analogue score(VAS)of lumbar pain and Oswestry dysfunction index(ODI)were used to evaluate the improvement of lumbar pain and functional scores in patients at 1 day,1 month,and 3 months after operation.At 3 months after surgery,magnetic resonance imaging was performed to assess the improvement of soft tissue injury.Repeated measurement analysis of variance was used for comparison of measurement data,andχ^(2) test was used for comparison of counting data.Results 12 to 24 hours after surgery,the pain relief rate in the observation group was significantly higher than that of control group(χ^(2)=13.254,P<0.05).The comparison of VAS and ODI scores at different time points before and after operation between the two groups showed intergroup effect(F=10.541 and 8.387,P<0.05).There were significant differences in lumbar VAS score and ODI index between the two groups 1 and 3 months after operation(P<0.05).At 3 months after surgery,the improvement rate of observation group was significantly higher than that of control group(χ^(2)=19.653,P<0.05).Conclusion Individual rehabilitation treatment can promote the early postoperative functional recovery of patients with thoracolumbar osteoporotic fractures with low back soft tissue,and effectively reduce the incidence of postoperative low back pain.
作者
张吉辉
于亮
顾勇杰
叶森琦
侯志鹏
赵刘军
Zhang Jihui;Yu Liang;Gu Yongjie;Ye Senqi;Hou Zhipeng;Zhao Liujun(Department of Spinal Surgery,Ningbo No.6 Hospital,Ningbo 315040,China;Ningbo University School of Medicine,Ningbo 315211,China)
出处
《中华老年病研究电子杂志》
2023年第3期26-30,共5页
Chinese Journal of Geriatrics Research(Electronic Edition)
基金
浙江省公益技术研究项目(LGF18C100004)
浙江省医药卫生科技计划项目(2022KY341)
宁波市自然科学基金项目(202003N4298)
