摘要目的：探讨主动直腿抬高锻炼对椎间孔镜髓核摘除患者术后康复的影响。方法选择2015年1月—2016年3月患有单节段腰椎间盘突出症行单侧经皮椎间孔镜髓核摘除术患者69例,随机分为干预组39例和常规组30例,干预组术后进行规律的主动直腿抬高锻炼护理干预,常规组予以传统常规康复训练方法。采用日本骨科协会( JOA)腰椎功能评分和Oswestry功能障碍指数问卷( ODI)评估患者术后康复情况,比较两组患者的腰部、患肢视觉模拟量表评分( VAS)评分,采用SPSS 21.0软件对数据进行统计学分析。结果两组患者在术后随访期间腰部VAS评分比较无统计学意义( P>0.05)；干预组术后1周、术后1月患肢VAS评分分别为(1.79±2.01)分,(1.38±0.90)分,低于常规组,差异有统计学意义(t值分别为2.173,2.015；P<0.05)。在术后1周和1月时,干预组ODI评分分别为(21.71±2.24)分,(18.31±1.99)分,低于常规组(t 值分别为2.425,2.388；P<0.05)；JOA 评分分别为(22.71±2.01)分,(22.30±1.85)分,高于常规组,差异有统计学意义(t值分别为2.326,2.104；P<0.05)。结论主动直腿抬高锻炼可以在椎间孔镜髓核摘除术后加快患者疼痛缓解和功能康复进程,对骨科微创神经根减压术后护理工作有一定的指导意义。

abstractsObjective To explore the effects of straight leg raising intervention in the rehabilitation of patients after transforaminal endoscopic discectomy ( TED) . Methods Totally 69 patients suffering from single level lumbar intervertebral disc herniation and received the treatment of transforaminal endoscopic discectomy from January 2015 to March 2016 were selected and randomly divided into the intervention group ( n=39) and the routine group ( n=30) . Patients in the intervention group received regularly postoperative straight leg raising intervention, while patients in the routine group received routine health education and nursing. Lumbar function score of Japanese Orthopaedic Association ( JOA) and Oswestry Disability Index questionnaire ( ODI) were used to assess patients′postoperative recovery status, and we compared the waist and limb visual analog scale score (VAS) score of patients between two groups by using SPSS 21.0 software for statistical analysis.Results There was no significant difference in the waist VAS score of patients in two groups during follow-up ( P>0.05); the limb VAS scores in the intervention group at 1 week and 1 month after surgery were (1.79±2.01) and (1.38± 0. 90), which were significantly lower than that in the routine group (t=2.173,2.015;P<0.05). There was no significant difference in the lumbar VAS scores between two groups (P>0.05). At 1 week and 1 month after surgery, the ODI scores were (21.71±2.24) and (18.31±1.99) in the intervention group, which was lower than that in the routine group (t=2.425,2.388;P<0.05); the JOA scores in the intervention group were (22.71± 2. 01) and (22.30±1.85), which were higher than that in the routine group (t=2.326,2.104;P<0.05). Conclusions The application of straight leg raising intervention after TED can improve the process of pain relief and functional rehabilitation in early nursing, which could contribute to the nursing efficacy after orthopaedic nerve root decompression.