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Objective@#To systematically evaluate the effects of the implementation of the cognitive behavior intervention program on the rehabilitation of patients with degenerative lumbar spine surgery.@*Methods@#6 Chinese-English databases, The Cochrane library, PubMed, EMBASE, Medline, CNKI, Wanfang, were used for the randomized controlled trial of cognitive behavioral intervention in patients undergoing degenerative lumbar surgery. Two researchers independently retrieved and extracted data and conducted meta-analysis using RevMan5.3 software.@*Results@#The meta analysis results of 7 literatures showed that the Oswestry dysfunction index questionnaire [MD=-9.55, 95%CI(-11.09,-8.02)] in the experimental group, pain VAS score [MD=-1.06, 95%CI(-1.70,-0.41)], fear of sport belief (TSK) [MD=-0.84, 95%CI(-1.41,-0.28)] were significantly superior to the control group (Z=12.21, 3.23, 2.93, P<0.01). The difference was statistically significant.@*Conclusion@#Perioperative cognitive behavior intervention can alleviate preoperative anxiety, effectively improve postoperative self-pain management level and the enthusiasm to participate in rehabilitation exercise, reduce the degree of functional disability, and improve the long-term quality of life after surgery.
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Objective To systematically evaluate the effects of the implementation of the cognitive behavior intervention program on the rehabilitation of patients with degenerative lumbar spine surgery. Methods 6 Chinese-English databases, The Cochrane library, PubMed, EMBASE, Medline, CNKI, Wanfang, were used for the randomized controlled trial of cognitive behavioral intervention in patients undergoing degenerative lumbar surgery. Two researchers independently retrieved and extracted data and conducted meta-analysis using RevMan5.3 software. Results The meta analysis results of 7 literatures showed that the Oswestry dysfunction index questionnaire [ MD=-9.55, 95% CI(-11.09,-8.02)] in the experimental group, pain VAS score [MD=-1.06, 95% CI(-1.70,-0.41)], fear of sport belief (TSK) [ MD=-0.84, 95% CI (-1.41,-0.28)] were significantly superior to the control group (Z=12.21, 3.23, 2.93, P<0.01). The difference was statistically significant. Conclusion Perioperative cognitive behavior intervention can alleviate preoperative anxiety, effectively improve postoperative self-pain management level and the enthusiasm to participate in rehabilitation exercise, reduce the degree of functional disability, and improve the long-term quality of life after surgery.
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Objective:To observe the effect of clinical pharmacists on the pain education in the patients with fracture. Methods:A total of 122 fracture patients with ASAⅠ/Ⅱaged 18-80 years were randomly divided into the intervention group (n=61) and the control group(n=61). The control group received the conventional orthopedic treatment..Flurbiprofen was injected for the postopera-tive analgesia,and if the pain VAS score was above 6,pethidine solution was given at the dose of 50 mg immediately. Based on the conventional treatment,the patients in the intervention group were educated by clinical pharmacist one day before the surgery,and then strengthened education was given after the surgery.The pain VAS score,and sleeping quality at 6h,24h,48h and 72h and satisfaction of pain management were compared between the groups.Results:The VAS score of the intervention group was significantly lower than that of the control group at 6 h,24 h,48 h and 72 h after the operation (P<0.05). The scores of sleeping quality in the intervention group at 6 h and 24 h after the operation were higher than those in the control group (P<0.05). The scores of patients' satisfaction were significantly higher in the intervention group than those of the control group (P<0.05). Conclusion: The clinical pharmacist's pain education can improve the degree of pain control and sleeping quality,increase the patients' satisfaction with pain control to a cer-tain extent.
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Objective To analyze the effect of evidence based practice on feeding after spinal operation. Methods To formulate an answerable question, find the best available evidence, appraise the evidence and formulate the recommendations by using the method of evidence-based medicine. A total of 60 postoperative patients who received spinal operation were divided into observation group and control group (30 cases in each group). Those patients in control group received the routine diet guidance and the guidelines for the standardization of intake and consumption after spinal cord surgery were used for patients in observation group. The outcomes were evaluated by postoperative recovery and complications of patients after spinal operation. Results There were no significant difference in the incidence of nausea, vomiting , bloating and celialgia in the 5 hours after surgery and 2 hours after feeding between the two groups (P>0.05). The incidence of thirst and hunger in the 5 hours after surgery in observation group were 3.33％(1/30) and 13.33％(4/30).The incidence of thirst and hunger in the 5 hours after surgery in control group were 80.00％(24/30) and 83.33％(25/30). There were statistically significant in the incidence of thirst and hunger in the 5 hours after surgery between the two groups (χ2=36.27, 24.09, P<0.05). There were not statistically significant in the time of anal exsufflation and first defecation time between the two groups(P>0.05). Conclusions Evidence-based practice in the use of guidelines for the standardization of intake and consumption after spinal cord surgery can guide clinical practice.
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Objective To investigate the common critical value (CV) of patients hospitalized in the department of spine surgery and to determine the corresponding management. Methods Medical records of patients between 2013 January and 2014 December were retrospectively reviewed. 47 cases with CV were noted. The following characteristics of CV were recorded and analyzed, including time-point at occurrence, type, reason and management. Results Most of the CVs (43/47, 91.5%) were detected between 8 am to 12 am, and between 17 pm and 21 pm. Overall, there were 24 cases of abnormal blood electrolyte (51.1%), 13 cases of abnormal routine blood test (27.7%), 5 cases of abnormal blood coagulation test (10.6%), and 1 case of abnormal TnT (2.1%). The remaining 4 cases including 2 cases detected in the night (1 case of abnormal blood gas test and 1 case of abnormal TnT) and 2 cases detected in the afternoon (1 case of positive blood bacteria culture and 1 case of low blood glucose level). Conclusions The most common CVs were summarized in the clinical practice. The findings have important clinical implications concerning the management of these CVs. In addition, preventive modality of daily nursing and standardization of medical management should be applied so as to ensure the safety of patients and rapid recovery.