腰椎间盘突出症患者术前自我效能感相关因素分析

Objective To study the preoperative self-efficacy of patients with lumbar disc herniation(LDH) and its influential factors. Methods Seventy-six patients with LDH underwent operation from June 2008 to March 2009 were enrolled in the current study. The patients were investigated with GSES,SAS,SDS and self-made general characteristics before operation. The data were analyzed with SPSS 11.5. Results The score of preoperative self-efficacy was 25. 84 ±6. 76. The course of disease, education level, patients' hobbits could affect self-efficacy (F = 15. 371,P<0.01;F = 18.078,P<0.01;t =2. 368,P<0. 05). Preoperative self-efficacy correlated negatively with the course of disease (r = - 0.541, P < 0. 01). And preoperative self-efficacy correlated with education level and hobbits(r = 0. 589, P < 0. 01; r = 0. 226, P < 0.05) . The score of preoperative dysphoria and depression was significantly higher than norm (P < 0. 01) . Preoperative self-efficacy correlated negatively with dysphoria and depression (r = -0. 494, P < 0.01; r = - 0. 443, P < 0. 01). Conclusions The score of preoperative self-efficacy with LDH is low; the score of preoperative dysphoria and depression is high. Preoperative self-efficacy correlated negatively with the course of disease. And preoperative self-efficacy correlated with education level and hobbits; Preoperative self-efficacy correlated negatively with preoperative dysphoria and depression.     

腰椎间盘突出症患者术前自我效能感相关因素分析

Objective To study the preoperative self-efficacy of patients with lumbar disc herniation(LDH) and its influential factors. Methods Seventy-six patients with LDH underwent operation from June 2008 to March 2009 were enrolled in the current study. The patients were investigated with GSES,SAS,SDS and self-made general characteristics before operation. The data were analyzed with SPSS 11.5. Results The score of preoperative self-efficacy was 25. 84 ±6. 76. The course of disease, education level, patients' hobbits could affect self-efficacy (F = 15. 371,P<0.01;F = 18.078,P<0.01;t =2. 368,P<0. 05). Preoperative self-efficacy correlated negatively with the course of disease (r = - 0.541, P < 0. 01). And preoperative self-efficacy correlated with education level and hobbits(r = 0. 589, P < 0. 01; r = 0. 226, P < 0.05) . The score of preoperative dysphoria and depression was significantly higher than norm (P < 0. 01) . Preoperative self-efficacy correlated negatively with dysphoria and depression (r = -0. 494, P < 0.01; r = - 0. 443, P < 0. 01). Conclusions The score of preoperative self-efficacy with LDH is low; the score of preoperative dysphoria and depression is high. Preoperative self-efficacy correlated negatively with the course of disease. And preoperative self-efficacy correlated with education level and hobbits; Preoperative self-efficacy correlated negatively with preoperative dysphoria and depression.     

腰椎间盘突出症患者术后康复锻炼自我效能及其影响因素的调查

目的 描述腰椎间盘突出症患者术后康复锻炼自我效能水平,分析患者术后康复锻炼自我效能的影响因素。方法 采用方便抽样法选取2016年1月至6月在上海市第六人民医院骨科脊柱外科病区实施腰椎后路减压融合内固定术的患者120例为研究对象。采用自行设计患者一般资料量表、一般自我效能感量表和腰椎JOA评分表分别于患者术前和术后6个月对患者进行调查。结果 数据的单因素分析可以看出,自我效能感与职业,家庭成员之间关系,医疗费用来源,年龄,体重指数以及腰椎JOA术后评分,改善指数和改善率是相关的。数据的多元线性回归分析显示：职业,年龄,体重指数和改善指数是自我效能感的影响因素。结论 护理人员对职业为农民或家务的患者、年龄较大的患者、体重指数较高的患者给予更多的康复指导和鼓励,以提高患者的康复锻炼自我效能水平和增强康复效果。     

腰椎间盘突出症患者疼痛、自我效能和生活质量的相关性研究

目的 调查腰椎间盘突出症患者疼痛、自我效能和生活质量状况,探讨其相互关系.方法 采用简式McGill疼痛问卷、疼痛自我效能量表、SF - 36健康调查表,对100例腰椎间盘突出症患者进行调查.结果 腰椎间盘突出症患者疼痛分级指数为(9.77±4.66)分,视觉模拟量表得分(52.08±14.56)分,现时疼痛强度(2....     

腰椎间盘突出症患者术后恐动症现状及影响因素分析

目的:调查腰椎间盘突出症(LDH)患者术后恐动症现状及影响因素,为后期开展康复锻炼提供依据。方法:应用一般资料调查表、视觉模拟评分法(VAS)、恐动症评估量表(TSK)、自我效能量表(GSES)、家庭关怀指数量表(APGAR)对131例LDH手术患者进行横断面调查。结果:78.62%的LDH患者术后存在恐动症;Logistic回归分析显示,术后疼痛程度及患者的自我效能是其主要影响因素。结论:LDH患者术后恐动症发生率较高,有效缓解术后疼痛及提升患者自我效能可降低恐动症的发生率,促进患者康复锻炼及功能恢复。     

自我管理模式在腰椎间盘突出症患者中的应用效果评价

目的探讨自我管理模式在腰椎间盘突出症患者中的应用效果。方法采用随机数字表法,将77例腰椎间盘突出症患者分为观察组(38例)和对照组(39例)。观察组采用自我管理干预6个月,对照组进行常规指导。分别在干预前、患者出院后第3个月、患者出院后第6个月评价两组患者自我效能、疼痛和功能障碍程度。结果观察组干预后不同时间点患者自我效能得分高于干预前水平,并且高于对照组(P<0.05);观察组干预后功能障碍、疼痛视觉模拟量表得分低于干预前,且低于对照组(P<0.05)。结论自我管理模式能有效提高腰椎间盘突出症患者的自我效能水平,减轻患者的疼痛和功能障碍程度。     

自我效能干预对腰椎间盘突出症康复治疗患者负性情绪及疼痛程度的影响

目的:探讨增强自我效能干预对腰椎间盘突出症康复治疗患者负性情绪及疼痛程度的影响。方法:将我院收治的60例腰椎间盘突出症康复治疗患者随机等分为对照组和观察组,对照组给予常规护理干预,观察组给予强化自我效能干预。结果:观察组自我效能评分、自我管理能力评分显著高于对照组,观察组疼痛程度显著低于对照组,两组比较差异有统计学意义(P0.05)。结论:对腰椎间盘突出症康复治疗患者进行自我效能干预,可提高患者自我效能及自我管理能力,改善患者焦虑、抑郁的情绪,有效缓解其疼痛程度。     

Orem自理护理模式对腰椎间盘突出症患者自我效能及锻炼依从性的影响

目的探讨Orem自理护理模式对腰椎间盘突出症患者自我效能及锻炼依从性的影响。方法2016年1月至2017年12月选取解放军第九五医院骨科收治的腰椎间盘突出症患者140例,根据随机数字表分为观察组及对照组,各70例。对照组行骨科常规性健康教育,观察组围术期应用Orem自理护理模式实施干预。比较两组患者自我效能、锻炼依从性及生活质量改善情况。结果观察组治疗优良率、疾病知识知晓率、锻炼依从率均高于对照组,并发症发生率和视觉模拟评分(VAS)较对照组明显下降,自我效能评分、日本骨科协会评估治疗(JOA)评分、生活质量评分均高于对照组,差异均有统计学意义(P<0.05)。结论Orem自理护理模式可提高腰椎间盘突出症患者自我效能及治疗依从性,促进患者预后,提高患者生活质量。     

腰椎间盘突出症患者围手术期护理

对施行手术治疗的２８４例腰椎间盘下患者进行了围手术期护理,手术成功率达９３．７％。护理内容包括术前 志调理,体位及二便训练,术中呼吸调控,反应２的观察,一观察重点,护理及功能锻炼的指导。提示：对腰椎间盘突出症患者术前、术中、术后第一环节的细致观察及护理,是手术成功不可缺少的条件。     

腰椎间盘突出症患者的康复护理

目的:探讨康复护理干预腰椎间盘突出症患者在康复中的疗效。方法:回顾性分析2004年1月～2009年10月我科收治的264例腰椎间盘突出症患者资料,采用理疗、牵引、电脑中频治疗配合整体康复护理。结果:经过14～21 d的治疗,显效220例,有效44例。结论:临床上常规的康复治疗配合康复护理能显著提高腰椎间盘突出症患者的整体功能恢复。     

腰椎间盘突出症的护理

目的:探讨中西医结合护理对腰椎间盘突出症非手术治疗的临床效果。方法:总结140例腰椎间盘突出症患者非手术治疗的护理,包括生活、饮食、牵引的护理、针灸护理、功能锻炼等中西医结合护理。结果:140例患者中治愈115例,占82.1%;好转20例,占14.3%;无效5例,占3.6%。结论:中西医结合护理能有效地减轻患者的痛苦,缩短病程,提高疗效。     

胶原酶注射治疗腰椎间盘突出症150例

目的：评估腰椎间盘突出症胶原酶溶解术的临床应用,方法：150例腰椎间盘突出症选择病例行椎间盘内及盘外胶原酶注射,患者随访1年,评估其疗效。结果：胶原酶溶解术的总有效率达82％（123／150）,两例合并椎间盘感染,无其他并发症,结论：胶原酶注射是治疗腰椎间盘突出症的有效方法之一。     

医用臭氧治疗腰椎间盘突出症

目的评价经皮椎间盘内医用臭氧注射治疗腰椎间盘突出症的疗效.方法 124例腰椎间盘突出症患者在透视下用21 G酒精针穿刺病变椎间盘并注射浓度为40 μg/ml的臭氧气体6～10 ml,退针至椎间孔附近时,向椎旁组织内注入臭氧10 ml.结果 124例患者随访6～18个月,显效31.5 %,有效45.1 %,无效23.4 %,总有效率76.6 %.大多数患者在术后0.5个月至1个月时取得较好的疗效.未发现严重并发症.结论经皮椎间盘内医用臭氧注射是治疗腰椎间盘突出症的一种有效、安全的微创方法.     

药磁腰托对腰椎间盘突出症患者血液流变学的影响

目的　观察药磁腰托对腰椎间盘突出症患者血液流变学的影响。方法　将符合病例入选标准的 60例腰椎间盘突出症患者随机分为试验组和对照组各 3 0例。对照组采用 :①腰椎牵引 ;②中频电疗法 ;③推拿按摩。试验组在此基础上增加药磁腰托治疗 (腰托内含磁片和中药 )。治疗前和治疗后 2周左右行血液流变学检测。将结果进行统计学分析 (t检验 )。结果　治疗后 2组患者血液流变学大多数指标均较治疗前有所改善 (P <0 .0 5或P <0 .0 0 1) ;但 2组间比较 ,试验组的全血粘度、血浆粘度、红细胞聚集率等血液流变学指标的改善情况优于对照组 (P <0 .0 5 )。结论　药磁腰托能有效降低腰椎间盘突出症患者的血液粘度 ,改善血液流变性。     

Association between pain and gait instability in patients with lumbar disc herniation

ObjectiveTo determine whether pain is associated with gait instability in patients with lumbar disc herniation (LDH).MethodsThis retrospective cross-sectional study used data from electronic medical records. Among patients with lumbar back pain caused by LDH between January 2017 and July 2019, patients that underwent gait analysis were included. LDH was diagnosed using magnetic resonance imaging. An OptoGait photoelectric cell system was used for gait evaluation. Instability was measured using a gait symmetry index. Multivariate linear regression analysis was performed to determine the association between lumbar pain and gait instability.ResultsA total of 29 patients (12 females [41.4%] and 17 males [58.6%]; mean ± SD age, 40.6 ± 12.0 years) with LDH were enrolled in the study. With each 1-point increase in lumbar pain on the numeric rating scale, the symmetry index of the stance phase (0.33; 95% confidence interval [CI] 0.04, 0.62), swing phase (0.78; 95% CI 0.14, 1.43) and single support (0.79; 95% CI 0.15, 1.43) increased.ConclusionsGait instability in patients with LDH may occur due to an increase in pain.     

Reliability of B-mode ultrasonography to measure lumbar multifidus muscle dimensions in patients with unilateral lumbar disc herniation

ObjectivesTo evaluate Ultrasound Imaging (USI) reliability for measurement of lumbar multifidus (LMF) muscle thickness and cross sectional area (CSA) at rest and during contraction in patients with unilateral lumbar disc herniation.SettingLaboratory.DesignReliability Study.ParticipantsThirty patients, aged 25–50 years (37.55 ± 9.55), with unilateral L4-L5 lumbar disc herniation participated in this study.Main outcome measuresThickness and CSA of LMF were measured using B-mode ultrasound by two raters in prone position.ResultsSame day and multiple day inter-rater and same day intra-rater reliability showed good to excellent reliability (intraclass correlation coefficients ranged from 0.70 to 0.91). Also standard error of measurement and minimal detectable change for USI reliabilities ranged from 0.06 to 0.57 and 0.16 to 1.31, respectively.ConclusionsReliability of USI for measurements of LMF muscle thickness and CSA was high, and consistent with previous studies conducted on reliability of USI to measure LMF dimensions in other populations.