目的 系统比较小针刀、局部浸润麻醉及两者联合疗法治疗腰椎间盘突出症（LDH）的临床疗效。方法 采用前瞻性随机对照设计，选取2023年1月—2025年1月收治的120例保守治疗无效的LDH患者，随机分为小针刀组（A组，n=40）、局部浸润麻醉组（B组，n=40）和联合治疗组（C组，n=40）。A组实施标准化小针刀松解术，采用“三点九刀”布点法松解粘连组织；B组采用超声引导下椎间孔外口及关节突关节囊周围利多卡因联合曲安奈德浸润麻醉；C组实施“麻醉-松解序贯疗法”（即先B组方案，后A组方案）。比较三组治疗前后视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、腰椎活动度（ROM）、表面肌电图（sEMG）、疼痛压力阈值（PPT）及改良Macnab优良率。结果 治疗后，三组VAS、ODI评分均较治疗前下降（P＜0.001）。组间比较显示，C组VAS（2.08±0.90分）、ODI（14.65±3.70分）改善显著优于A组（3.80±1.20分，21.00±4.25分）和B组（3.93±1.15分，22.10±4.65分）（均P＜0.05），A、B两组间无统计学差异（P＞0.05）。C组在腰椎前屈ROM（67.78±9.18°）、竖脊肌静息sEMG比值（0.19±0.05）、腰椎旁PPT（4.60±0.91 kg/cm²）上亦显著优于A、B两组（均P＜0.05）。改良Macnab评价显示C组优良率达85.00%（34/40），高于A组的52.50%（21/40）和B组的55.00%（22/40）（P＜0.05）。结论 小针刀与局部浸润麻醉单一疗法对LDH均有效，但联合应用可产生多模式协同效应，通过阻断疼痛传导、调节炎性微环境和改善生物力学失衡，在缓解疼痛、促进功能恢复及改善客观生理指标方面均展现出显著优势，为中西医结合治疗LDH提供了更优化的创新性方案，具有重要临床推广价值。

      Objective To systematically evaluate and compare the clinical effectiveness and mechanistic actions of acupotomy，local infiltration anesthesia，and their combination in treating lumbar disc herniation（LDH）．Methods This prospective，randomized controlled trial included 120 LDH patients unresponsive to conservative management，admitted between January 2023 and January 2025．Participants were randomly allocated to three groups：the Acupotomy Group（Group A，n=40）receiving standardized acupotomy release with a “three-point nine-needle” technique to address adhesions；the Local Infiltration Anesthesia Group（Group B，n=40）receiving ultrasound-guided infiltration of lidocaine combined with triamcinolone acetonide around the extraforaminal outlet and facet joint capsule；and the Combined Therapy Group（Group C，n=40）undergoing a sequential “anesthesia-release” protocol（first applied Group B therapy then Group A therapy）．Assessments conducted before and after treatment included the Visual Analog Scale（VAS），Oswestry Disability Index（ODI），lumbar range of motion（ROM），surface electromyography（sEMG），pain pressure threshold（PPT），and the modified Macnab criteria．Results Following treatment，significant reductions from baseline were observed in VAS and ODI scores across all three groups（P＜0.001）．Between-group comparisons indicated that Group C achieved significantly greater improvement in VAS（2.08±0.90）and ODI scores（14.65±3.70）compared to Group A（3.80±1.20；21.00±4.25）and Group B（3.93±1.15；22.10±4.65）（all P＜0.05），with no significant difference between Groups A and B（P＞0.05）．Group C also showed superior outcomes in lumbar flexion ROM（67.78±9.18°），the resting sEMG amplitude ratio of the erector spinae muscles（0.19±0.05），and paravertebral PPT（4.60±0.91 kg/cm²）compared to the other two groups（all P＜0.05）．Based on the modified Macnab criteria，the excellent-good rate was 85.00%（34/40）in Group C，significantly higher than the rates of 52.50%（21/40）in Group A and 55.00%（22/40）in Group B（P＜0.05）．Conclusions While both acupotomy and local infiltration anesthesia as standalone treatments are effective for LDH，their combined application produces a multimodal synergistic effect．This integrated strategy，which concurrently interrupts pain signaling，modulates the local inflammatory milieu，and ameliorates biomechanical dysfunction，demonstrates significant advantages in pain relief，functional recovery，and normalization of objective physiological measures．The findings present an optimized and novel integrative approach for LDH management，highlighting its considerable potential for broader clinical adoption．

       目的  分析改良经脊柱内椎间孔镜系统技术（TESSYS）对腰椎间盘突出症患者疼痛及功能的影响，以期分析该术式优劣，丰富该研究领域。方法  回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象，根据治疗方式的不同划分为观察组（TESSYS技术治疗）和对照组（经皮椎间孔镜髓核摘除术治疗），每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况，比较两组患者术前及术后1个月腰椎功能情况，包括Oswestry功能障碍指数（ODI）、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平。结果   观察组患者疗效优于对照组（Z=-3.737，P＜0.001）。交互效应下，两组疼痛因不同术式而随着时间增加而有所不同（P＜0.05）；时点效应下，观察组、对照组各组均随着时点增加疼痛随之减少（P＜0.05）；组间效应下，干预前、干预后1个月两组差异不明显，但是观察组疼痛干预后6 h（Z=-2.831，P=0.005）、干预后1天（Z=-3.253，P=0.001）低于对照组。术后1个月，观察组患者的ODI（Z=-4.804，P＜0.001）低于对照组，而腰椎曲度（Z=-6.218，P＜0.001）、腰背肌后伸活动度（Z=-7.014，P=0.001）高于对照组。术后24 h后，观察组患者的hs-CRP（Z=-5.671，P＜0.001）、IL-6（Z=-3.262，P＜0.001）低于对照组。结论  TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势，可提高疗效，减少出血量，减轻疼痛，减少炎症反应，加快腰椎功能康复，缩短住院时间。

       Objective  The effect of modified transforaminal endoscopic spine system（TESSYS） on pain and function in patients with lumbar disc herniation was analyzed，so as to analyze the advantages and disadvantages of this procedure and enrich the research field．Methods  Retrospectively，80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects．These patients were divided into two groups based on their treatment methods：the observation group（treated with TESSYS technology）and the control group（treated with percutaneous endoscopic discectomy）．Each group consisted of 40 patients．The study evaluated the treatment efficacy，surgical duration，intraoperative bleeding volume，hospital stay fluoroscopy frequency，and incision length for both groups．Additionally，we compared the VAS  scores of  both groups before surgery，six hours post-surgery，one day post-surgery，one week post-surgery，and one month post-surgery．We also compared the lumbar function of both groups before surgery and 1 month post-surgery，including the Oswestry Functional Index（ODI），lumbar lordosis，and lumbar back muscle extension activity．Furthermore，we compared the serum levels of high-sensitivity C-reactive protein（hs-CRP）and interleukin-6（IL-6）in both groups before and 24 hours after surgery．Results  The therapeutic effect of the observation group was better than that of the control group（Z=-3.737，P＜0.001）．Under the interaction effect，the pain of the two groups varied with time due to different surgical procedures（P＜0.05）．Under the time effect，both the observation group and the control group showed a decrease trend in pain as the time to treatment increased（P＜0.05）．Under the inter group effect，there was no significant difference between the two groups before and 1 month after intervention，but the pain in the observation group was less than that in the control group at 6 hours after intervention（Z=-2.831，P=0.005）and 1 day after intervention（Z=-3.253，P=0.001）．One month after surgery，the ODI（Z=-4.804，P＜0.001）of the observation group patients was lower than that of the control group，while the lumbar curvature（Z=-6.218，P＜0.001）and lumbar back muscle extension activity（Z=-7.014，P=0.001）were higher than those of the control group．Twenty-four hours after surgery，the hs-CRP（Z=-5.671，P＜0.001）and IL-6（Z=-3.262，P＜0.001）levels in the observation group were lower than those in the control group．Conclusions  The improved  percutaneous transforaminal endoscopic technique  has  significant advantages over  percutaneous transforaminal discectomy in the treatment of lumbar disc herniation．It can improve efficacy，reduce bleeding，alleviate pain，reduce inflammatory reactions，accelerate lumbar functional recovery，and shorten hospitalization time．

目的 探讨脊柱微调手法治疗产后腰椎-骨盆复合体疼痛的临床疗效及对腰椎前凸曲度（LL）和骨盆入射角度（PI）的调整作用,为产后腰椎-骨盆复合体疼痛的治疗提供理论依据。方法 选取2022年7月—2023年7月在上海市杨浦区中医医院推拿科和上海中医药大学附属岳阳中西医结合医院推拿科门诊治疗的产后腰椎-骨盆复合体疼痛患者共82例,随机分为对照组和治疗组,每组41例。对照组采用传统理筋推拿手法,治疗组采用脊柱微调手法治疗,两组疗程均为8周,观察临床疗效,比较两组患者的疼痛数字评分法（NRS）、Oswestry功能障碍指数（ODI）、LL和PI在治疗前后组间与组内的变化。结果 治疗组总有效率为95.12%,对照组总有效率为75.60%,治疗组优于对照组（P<0.05）。治疗后,两组NRS评分、ODI评分较治疗前均有下降,且治疗组优于对照组（P<0.05）。治疗后,两组LL和PI测量较治疗前均无明显变化,治疗组与对照组比较差异无统计学意义（P>0.05）。结论 脊柱微调手法能有效减轻患者疼痛、提升日常活动功能,但对腰椎曲度、骨盆入射角未产生移位影响,安全性高。

Objective To explore the clinical efficacy of spinal fine adjustment manipulation in the treatment of postpartum lumbopelvic pain（PLPP） and its role in adjusting lumbar lordosis and pelvic incidence,and to provide theoretical basis for the treatment of PLPP. Methods A total of 82 patients with PLPP who were treated in the outpatient clinics of the Tuina Department of Yangpu District Hospital of Traditional Chinese Medicine and the Tuina Department of Yueyang Hospital of Integrative Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from July 2022 to July 2023 were selected and randomly divided into the control group and the treatment group,with 41 cases in each group．The control group was treated with the traditional tendon manipulation and the treatment group was treated with spinal fine adjustment manipulation,and the course of treatment for both groups was 8 weeks．Clinical efficacy was observed,and the changes of pain Numerical Rating Scale（NRS）,Oswestry disability index（ODI）,lumbar lordosis（LL）,and pelvic incidence（PI）of the two groups were compared between the two groups and within the two groups before and after the treatment. Results The total effective rate was 95.12% in the treatment group and 75.60% in the control group,and the treatment group was superior to the control group（P<0.05）．After treatment,the NRS and ODI of both groups were lower than before treatment,and the treatment group was better than the control group（P<0.05）． After treatment,there was no significant change in LL and PI in both groups compared to pre-treatment．There was no significant difference between the treatment group and the control group（P>0.05）. Conclusions Spinal fine adjustment manipulation can effectively reduce the pain of patients and improve the function of daily activities,but it has no displacement effect on LL and PI,which is safe and suitable for clinical promotion and application．

目的 分析在临床治疗腰椎间盘突出症过程中采取脊柱微创手术的价值。方法 回顾研究2019年2月-2021年2月本院的102例腰椎间盘突出症患者,按照电脑排序将患者分为参照组51例与研究组51例。其中,接受传统手术治疗的为参照组,接受脊柱微创手术治疗的为研究组,将不同方案下的效果进行对比。结果 研究组切口长度指标更低于参照组,术中出血量指标比较差异有统计学意义少于对照组,手术时间更短于参照组,比较差异有统计学意义（P<0.05）。研究组术后引流量指标均更低于参照组,术后活动时间及住院时间指标均更低于参照组,比较差异有统计学意义（P<0.05）。两组患者接受治疗前疼痛程度评分对比,无比较差异有统计学意义差异性（P>0.05）,治疗后研究组患者疼痛评分均更低于参照组,比较差异有统计学意义（P<0.05）。研究组治疗后并发症发生概率5.88%更低于参照组的21.57%,比较统计差异比较差异有统计学意义（P<0.05）。结论 在临床治疗腰椎间盘突出症过程中采取脊柱微创手术效果良好,比较差异有统计学意义地降低患者手术损伤,缓解了患者手术疼痛感,促进患者尽快术后康复,防止并发症的发生,适合于临床中应用。

目的 建立兔腰椎间盘严重退变骨水泥成形术模型并进行鉴定。方法 选用新西兰白兔6只,手术干预前摄腰椎正侧位X线片并进行MRI扫描Pfirrmann分级,之后通过腹外斜肌与腰大肌间隙入路手术去除兔腰2~3椎间盘髓核组织及部分纤维环模拟腰椎间盘严重退变状态。饲养6周后相应腰椎节段椎间盘进行MR扫描Pfirrmann分级,确认相应腰椎节段椎间盘符合严重退变影像表现后再次手术显露相应椎间隙并注入骨水泥。1周后再次摄腰椎正侧位X线片并行MRI扫描Pfirrmann分级,终末处死并解剖动物检查椎间盘内骨水泥填充情况。结果 兔腰椎间盘退化模型建立6周后磁共振Pfirrmann分级为Ⅴ级。椎间隙骨水泥注射后1周其术后磁共振Pfirrmann分级为Ⅳ。骨水泥注射模型1周后拍摄手术节段X线片显示骨水泥较好地填充于腰2~3间隙,椎间隙高度接近正常状态。终末处死并解剖动物发现腰椎节段椎间盘内骨水泥填充良好无脱落或松动。结论 通过腹外斜肌与腰大肌间隙入路,手术去除椎间盘髓核组织及部分纤维环6周后,往椎间隙内注入骨水泥,可获得较为可靠的新西兰大白兔腰椎间盘严重退变骨水泥成形术的动物模型。

Objective To establish and identify the rabbit model of lumbar disc with severe degeneration．Methods Six New Zealand white rabbits were selected,lumbar X-ray and Pfirrmann grade by MR scan were performed before surgical intervention．Along the space of obliquus externus abdominis and psoas major,the front edge of L2 to L3 was exposed．Then,the nucleus pulposus and part of annulus fibrosus were removed to imitate severe degeneration of lumbar disc．After 6 weeks of rearing,the operated lumbar disc was graded by MR scan,confirming that the lumbar disc met the image of severe degeneration,and then exposed the intervertebral space and injected bone cement．One week later,the anterior lumbar X-ray and the MRI scan for Pfirrmann grading were taken．The animals were sacrificed and dissected to check the bone cement filling in the intervertebral disc．Results The rabbit MR Pfirrmann grade of intervertebral disk was V after 6 weeks of first operation．One week after intervertebral cement injection,the MR Pfirrmann grade was Ⅳ．The surgical segment X-ray was taken one week after the cement injection,which showed that the cement was well filled in the L2-L3 gap and the vertebral space height was close to normal．Animals were sacrificed and dissected,the lumbar intervertebral disc was well filled with cement without shedding or loosening．Conclusions A reliable animal model of lumbar disc with severe degeneration in New Zealand white rabbits can be obtained by injecting cement into the intervertebral space after 6 weeks of removal of the intervertebral disc nucleus pulposus and part of the annulus fibrosus through the obliquus externus abdomins and psoas major intervertebral space．

目的 探讨自拟补肝益肾壮腰汤联合脊柱推拿、牵引对腰椎间盘突出症(LDH)患者肌电图和腰椎功能的影响及临床效果。方法 选取106例LDH患者采用随机数字表法分为观察组和对照组各53例。对照组行脊柱推拿及牵引治疗,观察组在此基础上加用自拟补肝益肾壮腰汤。记录2组患者治疗前及治疗3个月后的腰椎功能程度[Oswestry功能障碍指数(ODI)]、肌电图[平均功率频率(MPF)、中位频率斜率(MFs)、平均肌电波幅(AEMG)]、运动功能障碍程度[日本骨科协会下腰痛量表(JOA)]及疼痛程度[视觉模拟评分法(VAS)]评估结果差异。结果 治疗3个月后,2组JOA评分、VAS评分及各项肌电图参数(MPF、MFs、AEMG)均较治疗前有提升,且观察组均高于对照组(P均＜0.05);ODI评分则较治疗前下降(P均＜0.05),且观察组低于对照组(P＜0.05)。结论 自拟补肝益肾壮腰汤联合脊柱推拿及牵引能明显改善LDH患者腰椎功能,促进肌力恢复、缓解肌肉疲劳、减轻疼痛,有较高的临床实用价值。

Objective To investigate the effect of self-made Bugan Yishen Zhuangyao decoction combined with spinal massage and traction on electromyography and lumbar function and clinical efficacy in patients with lumbar disc herniation (LDH). Methods A total of 106 patients with LDH were randomly divided into observation group and control group. The control group was treated with spinal massage and traction, and the observation group was treated with self-made Bugan Yishen Zhuangyao decoction on this basis. The degree of lumbar spine function [Oswestry disability index (ODI)], electromyography [mean power frequency (MPF), median frequency slope (MFS), average EMG amplitude (AEMG)], the degree of motor dysfunction [Japanese Orthopaedic Association (JOA) score] and the degree of pain [visual analog scale (VAS)] before and 3 months after treatment were recorded and compared. Results After 3 months of treatment, JOA score, VAS score and EMG parameters (MPF, MFS and AEMG) in the two groups were significantly higher than those before treatment, and those in the observation group were higher (P<0.05); ODI score was significantly lower than that before treatment (all P<0.05), and the observation group was significantly lower than the control group (P<0.05). Conclusions The self-made Bugan Yishen Zhuangyao decoction combined with spinal massage and traction can significantly improve the lumbar function of patients with LDH, promote the recovery of muscle strength, relieve muscle fatigue and pain, and with high clinical practical value.

目的 观察椎间孔镜下腰椎间盘突出症的近期疗效,分析不同年龄段对手术疗效的影响。方法 收集120例腰椎间盘突出患者,分成A、B、C三个研究小组:A青年组(年龄≤44岁)、B中年组(44岁<年龄<65岁)、C老年组(年龄≥65岁)。以术前、术后1天、术后3月、术后6月为界限,分析患者的疼痛视觉模拟量表(VAS)评分,并计算相对应的腰椎Oswestry功能障碍指数;术后1年用改良Macnab标准评价疗效优良率。结果 针对不同试验小组的VAS评分、ODI指数等进行对比分析:术后1天的对比差异不存在统计学意义(P>0.05);术后3个月、6个月比较差异有统计学意义(P<0.05),其中C组术后3月、6月VAS评分、ODI指数高于A、B组,差异有统计学意义(均P<0.05),A、B组间比较无统计学差异(P>0.05)。术后1年三组间疗效优良率比较无统计学差异(P>0.05)。结论 不同年龄段患者椎间孔镜的近期疗效显著,中青年患者恢复快,中期疗效好。

Objective To observe the short-term curative effect of transforaminal endoscopy for lumbar disc herniation, and to analyze the influence of different age on the curative effect. Methods 120 patients with lumbar disc herniation were collected, the study was divided into three groups: group A, group B and group C: group A (young adults, 44 years or older), group B (44 years or older) and group C (65 years or older). The visual analogue scale (Vas) scores of the patients were analyzed and the corresponding Oswestry index of the lumbar spine was calculated according to the preoperative, 1 day, 3 months and 6 months postoperatively. A modified Macnab was used to evaluate the rate of excellency and good results 1 year after operation. Results The Vas score and Odi index of different groups were compared. There was no statistically difference at 1 day after operation (P > 0.05). After 3 months and 6 months, there was statistically difference (P<0.05), among them, the VAS scores and Odi index of group C were higher than those of group B, the difference was statistically significant (P<0.05), there was no statistically difference between group A and group B (P > 0.05). There was no statistically difference between the three groups in the first year after operation (P > 0.05). Comparison of VAS score and ODI index among the three groups: there was no statistically difference at 1 day after operation (P>0.05); there was statistically difference at 3 months and 6 months after operation (P<0.05), among which VAS score and ODI index of group C were higher than those of group A and group B (all P<0.05), but there was no statistically difference between group A and group B (P>0.05). There was no statistically difference in the excellent and good rate among the three groups one year after operation (P>0.05). Conclusion The short-term curative effect of intervertebral foramina in patients of different ages is remarkable, the young and middle-aged patients recover quickly, and the medium-term curative effect is good.

目的 比较唑来膦酸对 PVP(椎体成形术)治疗OVCF(骨质疏松椎体压缩性骨折)术后再发骨折的影响。方法 收集2016年12月—2018年6月在我院骨科接受PVP治疗患者共70例,其中40人在术后接受了唑来膦酸治疗(观察组),30人在术后接受了安慰剂治疗(对照组),两组患者均给予维生素D和钙剂基础治疗。记录术后6个月、1年、2年腰椎骨密度;术后2年内伤椎及邻近椎体再发骨折情况。结果 观察组伤椎再发骨折率(1/40,2.5%)低于对照组(2/30,6.67%)(P＜0.05);观察组邻椎再发骨折率(2/40,5%)低于对照组(7/30,23.33%)(P＜0.05)。结论 唑来膦酸能较好地预防PVP术后再发骨折。

Objective To compare the effect of zoledronic acid on the treatment of osteoporotic vertebral compression fracture after percutaneous vertebroplasty PVP. Methods From December 2017 to June 2019, a total of 70 patients who received PVP in the hospital medical plastic surgery clinic, 40 patients were collected received zoledronic acid (group A) and 30 patients received placebo (group B) after operation. Both groups received basic treatment of vitamin D and calcium. The bone mineral densits (BMD) of lumbar vertebrae were recorded at 6 months, 1 year and 2 years after operation, and the recurrent fractures of injured vertebrae and adjacent vertebrae were recorded at 2 years after operation. Results The rate of recurrent fracture of vertebrae in group A (1/40, 2.5%) was lower than that in group B (2/30, 6.67%); the rate of recurrent fracture of adjacent vertebrae in group A (2/40, 5%) was grcartly lower than that in group B (7/30, 23.33%). Conclusion Zoledronic acid can prevent recurrent fracture after PVP.

目的 探究椎间孔镜下治疗腰椎间盘突出症切除黄韧带对腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度的影响。方法 选择120例腰椎间盘突出症患者,随机分为观察组与对照组各60例。观察组患者椎间孔镜术中切除部分黄韧带;对照组患者保留黄韧带。比较两组患者术后半年、1年及2年的腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度。结果 观察组术后半年、1年腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度与对照组比较(P＞0.05)。观察组术后2年与对照组比较(P＜0.05)。结论 椎间孔镜下治疗腰椎间盘突出症保留黄韧带术后腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度远期效果优于切除黄韧带。

Objective To explore the effects of ligamentum flavum resection on lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space. Methods 120 patients with lumbar disc herniation were randomly divided into observation group and control group. In the observation group, part of the ligamentum flavum was excised by endoscope and in the control group, the ligamentum flavum was preserved. The lumbar lordosis angle, sacral inclination angle, lumbar curve index and intervertebral space height of the two groups were compared at 6 months, 1 year and 2 year after operation. Results At 6 months, 1 year after operation, the lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space in the observation group were compared with those in the control group(P＞0.05). 2 years after operation, the observation group was compared with the control group(P<0.05). Conclusion The long-term effect of ligamentum flavum preserving on lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space is better than that of ligamentum flavum resection.

目的 探讨腰椎间盘手术护理路径对经皮椎管成型下腰椎间盘摘除手术患者腰腿功能康复效果。方法 选择2018年1月—2019年11月住院进行经皮椎管成型下腰椎间盘摘除手术患者60例,按住院时间先后分为对照组和实验组各30例,对照组患者术后按椎间盘摘除手术给患者进行病情观察、腰腿功能康复锻炼、腰围配戴和康复护理知识宣教等护理;实验组患者在实施对照组护理措施基础上按腰椎间盘手术护理路径对患者进行有计划的康复护理知识宣教,按制定的康复护理路径对患者进行个性化康复活动训练指导。术后1周和出院时分别对患者掌握康复护理训练知识、腰椎功能障碍指数(ODI)、服务满意度进行评价。结果 实验组患者在术后首次进行康复训练时间早于对照组,差异有统计学意义(P=0.000 4);掌握康复护理知识得分实验组高于对照组,差异有统计学意义(P=0.002 3);掌握康复训练活动实验组高于对照组,差异有统计学意义(P<0.05);腰椎功能障碍指数(ODI)实验组低于对照组,差异有统计学意义(P<0.05);护理服务满意度实验组高于对照组,结果差异有统计学意义(P<0.05)。结论 椎间盘手术护理路径能促进患者早期进行康复训练,提高患者对腰椎间盘术后康复护理知识和康复训练技能的掌握,降低患者腰椎功能障碍指数,促进术后患者机体功能的康复。

Objective To explore the effect of nursing path of lumbar disc operation on the rehabilitation of lumbar and leg function in patients undergoing percutaneous laminoplasty. Methods From January 2018 to November 2019, 60 patients who were hospitalized for percutaneous laminoplasty were divided into the control group and the experimental group with 30 patients in each group according to the length of stay. The patients in the control group were given nursing care including condition observation, waist and leg function rehabilitation exercise, waist circumference wearing and rehabilitation nursing knowledge propaganda and education after the operation. On the basis of the nursing measures of the control group, patients in the experimental group received the planned rehabilitation nursing knowledge education according to the nursing path of lumbar disc operation, and individualized rehabilitation activity training guidance according to the established rehabilitation nursing path. One week after the operation and at the time of discharge, the patients' mastery of rehabilitation nursing training knowledge, lumbar dysfunction index (ODI) and service satisfaction were evaluated. Results The first time of rehabilitation training in the experimental group was earlier than that in the control group, the results were statistically significant (P=0.000 4); the score of mastering rehabilitation nursing knowledge in the experimental group was higher than that in the control group, the results were statistically significant (P=0.002 3); the experimental group of mastering rehabilitation training activities was higher than that in the control group, the results were statistically significant (P<0.05); lumbar dysfunction index ODI in the experimental group was lower than that in the control group, the results were statistically significant (P<0.05); the satisfaction of nursing service in the experimental group was higher than that in the control group, the results were statistically significant (P<0.05). Conclusion The nursing path of lumbar disc surgery can promote the early rehabilitation training of patients, improve the mastery of postoperative rehabilitation nursing knowledge and rehabilitation training skills of patients, reduce the lumbar dysfunction index of patients, and promote the rehabilitation of patients' body function.