【摘要】 目的 探讨早期康复训练联合SLEEP-MAD模式干预对椎管内恶性肿瘤患者术后睡眠质量及康复情况的影响。方法 根据干预方式的不同将145例椎管内恶性肿瘤手术患者分为对照组（70例，早期康复训练）和联合组（75例，早期康复训练+SLEEP-MAD模式干预）。比较两组患者的睡眠质量[匹兹堡睡眠质量指数（PSQI）]、膀胱功能、疼痛程度[数字分级评分法（NRS）]和运动功能[Fugl-Meyer运动功能评估量表（FMA）]。结果 干预后，两组患者PSQI评分均低于本组干预前，联合组患者PSQI评分低于对照组，差异均有统计学意义（P﹤0.05）。干预后，联合组患者残余尿量、日间歇导尿量均明显少于对照组，反射性排尿时间明显短于对照组，最大膀胱容量、最大尿流速率均明显高于对照组，首次排尿时间明显长于对照组，差异均有统计学意义（P﹤0.01）。术后24 h、术后72 h、术后1周，联合组患者NRS评分均明显低于对照组，差异均有统计学意义（P﹤0.01）。干预后，两组患者上肢和下肢Fugl-Meyer评分均高于本组干预前，联合组患者上肢和下肢Fugl-Meyer评分均高于对照组，差异均有统计学意义（P﹤0.05）。结论 早期康复训练联合SLEEP-MAD模式干预能够有效提高椎管内恶性肿瘤患者的术后睡眠质量，降低疼痛程度，且有助于膀胱功能和运动功能恢复。更多还原

【Abstract】 Objective To investigate the influence of early rehabilitation training combined with SLEEP-MAD model intervention on postoperative sleep quality and rehabilitation status in patients with intraspinal malignant tumors.Method According to different intervention methods,145 patients with intraspinal malignant tumors who underwent surgery were divided into the control group(70 cases,early rehabilitation training) and the combined group(75 cases,early rehabilitation training+SLEEP-MAD model intervention).The sleep quality [Pittsburgh sleep quality index(PSQI)],bladder function,pain degree [numerical rating scale(NRS)] and motor function [Fugl-Meyer assessment(FMA)] of the two groups were compared.Result After the intervention,the PSQI scores of both groups were lower than those before intervention,the PSQI score of the combined group was lower than that of the control group,and the differences were statistically significant(P<0.05).After the intervention,the residual urine volume and daily intermittent catheterization volume in the combined group were significantly less than those in the control group,the reflex urination time was significantly shorter than that in the control group,the maximal bladder capacity and maximum urine flow rate were significantly higher than those in the control group,and the first urination time was significantly longer than that in the control group,the differences were statistically significant(P<0.01).At 24 hours,72 hours and 1 week after the operation,the NRS scores of the combined group were significantly lower than those of the control group,and the differences were statistically significant(P<0.01).After the intervention,the Fugl-Meyer scores of the upper and lower limbs in both groups were higher than those before the intervention,the Fugl-Meyer scores of the upper and lower limbs in the combined group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Early rehabilitation training combined with SLEEP-MAD model intervention can effectively improve the postoperative sleep quality of patients with intraspinal malignant tumors,reduce the degree of pain,and contribute to the recovery of bladder function and motor function.更多还原