| 潘美琪,胡凯利,徐咏连,等.基于即时适配干预理念的多联预康复管理策略在腰椎退行性疾病病人中的应用.骨科,2025,16(3): 243-249. |
| 基于即时适配干预理念的多联预康复管理策略在腰椎退行性疾病病人中的应用 |
| Application of multi-modal pre-rehabilitation management strategy based on the just-in-time adaptive intervention in patients with lumbar degenerative diseases |
| 投稿时间：2025-02-13 |
| DOI：10.3969/j.issn.1674-8573.2025.03.009 |
| 中文关键词: 即时适配干预 多联预康复 腰椎退行性疾病 |
| 英文关键词: Just-in-time adaptive intervention Multi-modal pre-rehabilitation Lumbar degenerative disease |
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| 中文摘要: |
| 目的 分析基于即时适配干预理念的多联预康复管理策略在腰椎退行性疾病（lumbar degenerative disease，LDD）病人中的应用及效果。方法 采用便利抽样法，选取2024年1月至8月我院脊柱外科收治的拟行手术治疗的腰椎退行性疾病病人100例，将2024年1月至4月收治的50例病人纳入对照组，2024年5月至8月收治的50例病人纳入观察组。对照组实施腰椎手术术前常规管理流程，观察组实施基于即时适配干预理念的多联预康复管理策略。观察两组病人干预前、术前1 d和术后5 d的运动功能、营养状况、心理状况，以及术后并发症发生情况和术后住院天数。结果 共纳入96例病人，对照组和观察组各48例。两组干预前各项指标及术前1 d血红蛋白值比较，差异均无统计学意义（P均＞0.05）；两组其余指标相比，观察组均优于对照组，差异均有统计学意义（P均＜0.05）。两组运动功能、营养状况和心理状况的组间效应、时间效应和交互效应均有统计学意义（P均＜0.05）。术后，观察组发生并发症1例，对照组发生7例，差异无统计学意义（P＞0.05）。观察组术后住院天数较对照组明显缩短[（6.54±2.52） d vs. （7.77±2.28） d]，差异有统计学意义（t=-2.508，P=0.014）。结论 基于即时适配干预理念的多联预康复管理策略聚焦预康复实践中的障碍因素，可明显改善腰椎退行性疾病病人运动功能、营养状况、心理状况及预后，临床效果良好。 |
| 英文摘要: |
| Objective To analyze the application and effectiveness of a multi-modal pre-rehabilitation management strategy based on the concept of just-in-time adaptive intervention in patients with lumbar degenerative diseases. Methods Convenience sampling was used to select 100 patients with lumbar degenerative diseases who were scheduled for surgical treatment in our spinal surgery department from January to August 2024. A total of 50 patients admitted from January to April 2024 were included in the control group, and 50 patients admitted from May to August 2024 were included in the observation group. The control group received routine preoperative management for lumbar surgery, while the observation group was subjected to a multi-modal pre-rehabilitation management strategy based on the concept of just-in-time adaptive intervention. The motor function, nutritional status, psychological status, postoperative complications, and length of hospital stay of two groups were observed on the day of the first intervention, one day before surgery, and 5 days after surgery. Results A total of 96 patients were included, with 48 in the control group and 48 in the observation group. There was no statistically significant difference in the pre intervention indicators and preoperative 1-day hemoglobin values between the two groups (P＞0.05). The other indicators of the two groups, the observation group was superior to the control group, and the differences were statistically significant (P＜0.05). There were statistically significant difference in group effects, time effects, and interaction effects on motor function, nutritional status, and psychological status between the two groups (P＜0.05). There was 1 case of postoperative complications in the observation group and 7 cases in the control group, with no statistically significant difference (P＞0.05). There was a statistically significant difference in the length of hospital stay between the two groups (P＜0.05). Conclusion The multi-modal pre-rehabilitation management strategy based on the concept of just-in-time adaptive intervention significantly improves motor function, nutritional status, psychological status, and prognosis in patients with lumbar degenerative diseases, and the clinical effect is good. |
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