Abstract:

Objective　To analyze the clinical value of fast track surgery in perioperative nursing of minimally invasive transforaminal interbody fusion. Methods　This was a randomized controlled trial. Ninety six patients treated with minimally invasive transforaminal interbody fusion in Puyang Traditional Chinese Medicine Hospital from March 2021 to October 2022 were divided into a control group and an observation group by the random number table method. The control group received routine nursing, and the observation group received fast track surgery combined with routine nursing. In the control group, there were 28 males and 20 females, aged (50.44±6.52) years. There were 25 males and 23 females in the observation group, aged (49.95±6.73) years. The differences of Japanese Orthopaedic Association (JOA) score, lumbar Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ) score, intervertebral space height, and coronal and sagittal Cobb angles of the two groups were observed and analyzed. Independent sample t test and χ² test were used. Results　Before surgery, there were no statistically significant differences in the JOA score, ODI score, or RMDQ score between the two groups (all P>0.05). The JOA scores of the observation group 72 h, 3 months, and 6 months after surgery [(20.44±1.39), (23.68±1.40) and (24.22±1.49)] were higher than those of the control group [(19.81±1.26), (22.75±1.35) and (23.49±1.42)] (t=2.327, 3.313, and 2.457; P=0.022, 0.001, and 0.016); the ODI scores of the observation group [(40.59±3.52), (34.37±4.25), and (31.67±4.83)] were lower than those of the control group [(42.23±3.20), (36.45±4.33), and (34.69±4.95)] (t=2.388, 2.375, and 3.028; P=0.019, 0.020, and 0.003); the RMDQ scores of the observation group [(16.68±1.67), (11.75±1.38), and (5.42±1.35)] were lower than those of the control group [(17.85±1.75), (12.42±1.39), and (6.12±41.38)] (t=3.351, 2.370, and 2.512; P=0.001, 0.020, and 0.014). Before and after surgery, there were no statistically significant differences in the intervertebral space height or coronal or sagittal Cobb angle between the observation group and the control group (all P>0.05). Conclusion　The integration of fast track surgery into the perioperative nursing of minimally invasive transforaminal interbody fusion can effectively improve the lumbar function, improve the quality of life, and promote patients to recover as soon as possible.

Key words:

Fast track surgery, Minimally invasive surgery, Transforaminal interbody fusion, Perioperative nursing

摘要：

目的　分析快速康复外科应用于微创经椎间孔椎间融合术围手术期护理中的临床价值。方法　本研究为随机对照试验。选择2021年3月至2022年10月于濮阳市中医医院采取微创经椎间孔椎间融合术治疗的患者96例，经随机数字表法分成对照组及观察组。对照组采取常规护理，观察组采取快速康复外科联合常规护理。对照组，男28例，女20例，年龄（50.44±6.52）岁。观察组，男25例，女23例，年龄（49.95±6.73）岁。观察分析两组患者的日本骨科协会（Japanese Orthopaedic Association，JOA）评分、腰椎Oswestry功能障碍指数（Oswestry Disability Index，ODI）、Roland-Morris功能障碍问卷表（Roland-Morris Disability Questionnaire，RMDQ）评分、椎间隙高度、冠状面及矢状面Cobb角度差异。采用独立样本t检验以及χ²检验。结果　术前，两组JOA评分、ODI评分、RMDQ评分差异均无统计学意义（均P>0.05）。术后72 h、3个月、6个月，观察组JOA评分（20.44±1.39）分、（23.68±1.40）分、（24.22±1.49）分高于对照组的（19.81±1.26）分、（22.75±1.35）分、（23.49±1.42）分（t=2.327、3.313、2.457，P=0.022、0.001、0.016）；观察组ODI评分（40.59±3.52）分、（34.37±4.25）分、（31.67±4.83）分低于对照组的（42.23±3.20）分、（36.45±4.33）分、（34.69±4.95）分（t=2.388、2.375、3.028，P=0.019、0.020、0.003）；观察组RMDQ评分（16.68±1.67）分、（11.75±1.38）分、（5.42±1.35）分低于对照组的（17.85±1.75）分、（12.42±1.39）分、（6.12±41.38）分（t=3.351、2.370、2.512，P=0.001、0.020、0.014）。术前及术后，观察组椎间隙高度、冠状面及矢状面Cobb角与对照组比较差异均无统计学意义（均P>0.05）。结论　将快速康复外科融入微创经椎间孔椎间融合术围手术期护理中，可有效改善患者腰椎功能，提升生活质量，促进患者尽快康复。

关键词:

快速康复外科, 微创手术, 经椎间孔椎间融合术, 围手术期护理