来源：风湿病与关节炎,2022,11（4）:21-25.

腰椎间盘突出症术后患者康复现状及影响因素分析（调查研究）

张　曼¹，张淑卿²

　　【摘　要】目的：了解腰椎间盘突出症术后患者的康复现状，并分析其相关因素。方法：选取2018年5月至2019年11月在河南省洛阳正骨医院（河南省骨科医院）手术后出院6个月以上腰椎间盘突出症患者206例。采用自制调查问卷记录可能对腰椎间盘突出症术后康复有影响的项目，采用日本骨科学会评估治疗（JOA）评分，Barthel指数评定量表调查患者的腰椎功能和日常生活能力。结果：①不同性别、年龄、职业、日常运动、家庭人均月收入、付费方式、体质量指数（BMI）、文化程度、病变节段、下肢肌力、病程、知识评价、下肢麻木、慢性病史腰椎间盘突出症术后患者的JOA评分比较，差异有统计学意义（P < 0.05）；不同年龄、职业、日常运动、家庭人均月收入、付费方式、BMI、文化程度、病变节段、下肢肌力、病程、知识评价、下肢麻木、慢性病史腰椎间盘突出症术后患者的Barthel指数评分比较，差异有统计学意义（P < 0.05）。②多重线性逐步回归显示，知识评价、日常运动、下肢肌力、病程进入腰椎功能评分的回归方程（R² = 0.653）。下肢肌力、日常运动、病程进入日常生活能力评分的回归方程（R² = 0.282）。结论：医务人员应重视患者术后的康复情况，采取有针对性的康复措施，拓展康复途径，加强康复知识宣教，减轻患者痛苦，提高患者生活质量。

　　【关键词】　腰椎间盘突出症；术后；康复；影响因素；调查分析

Analysis of Rehabilitation Status and Influencing Factors of Postoperative Patients with Lumbar Disc Herniation

ZHANG Man,ZHANG Shu-qing

　　【ABSTRACT】Objective:To probe the rehabilitation status of postoperative patients with lumbar disc herniation and analyze related factors.Methods:Two hundred and six patients with lumbar disc herniation discharged for more than 6 months after operation（from May 2018 to November 2019）in Luoyang Orthopedic-Traumatological Hospital of Henan Province（Henan Provincial Orthopedic Hospital）were selected.The self-made questionnaire was used to record the items that may have an impact on the postoperative rehabilitation of lumbar disc herniation.The JOA score and Barthel index were used to investigate their lumbar functions and daily activities.Results:①There were significant differences in JOA scores of patients with lumbar disc herniation after operation in terms of gender,age,occupation,daily exercise,family per capita monthly income,payment method,body mass index（BMI）,educational level,pathological segment,lower limb muscle strength,course of disease,knowledge evaluation,lower limb numbness and chronic history（P < 0.05）;There were significant differences in Barthel Index scores among patients of different ages,occupations,daily exercise,family per capita monthly income,payment method,BMI,educational level,pathological segments,lower limb muscle strength,course of disease,knowledge evaluation,lower limb numbness,and chronic history（P < 0.05）.②Multiple linear stepwise regression showed that knowledge evaluation,daily exercise,lower limb muscle strength and course of disease entered the regression equation of lumbar function score（R² = 0.653）.Lower limb muscle strength,daily exercise and course of disease entered the regression equation of activity of daily living（ADL）score（R² = 0.282）.Conclusion:Medical staff should pay attention to the postoperative rehabilitation of patients,take targeted rehabilitation measures,expand rehabilitation approaches,strengthen the publicity and education of rehabilitation knowledge,reduce their pain and improve their quality of life.

　　【Keywords】lumbar disc herniation;postoperative;rehabilitation;influencing factors;investigation and analysis