早期康复护理干预对脊髓损伤患者运动功能 恢复影响的回顾性研究

Retrospective Study on the Effect of Early Rehabilitation Nursing Intervention on Motor Function Recovery in Patients with Spinal Cord Injury

摘要: 目的：探讨早期康复护理干预对脊髓损伤(SCI)患者运动功能恢复的影响，为制定科学、高效的脊髓损伤康复护理方案提供临床依据。方法：采用回顾性研究方法，选取2022年1月至2025年12月在本院康复医学科及骨科住院治疗的42例脊髓损伤患者作为研究对象，根据护理干预方式的不同分为观察组(21例)和对照组(21例)。对照组患者采用常规康复护理模式，包括基础护理、病情观察、常规健康指导及简单功能锻炼指导；观察组患者在对照组的基础上实施早期康复护理干预，于患者生命体征平稳、病情稳定后48~72 h内启动，涵盖体位护理、关节活动训练、肌力训练、平衡与协调训练及康复健康教育等个性化干预措施。比较两组患者干预前、干预1个月、干预3个月的运动功能(采用Fugl-Meyer运动功能评定量表，FMA)、日常生活活动能力(采用Barthel指数评定量表，BI)，同时记录两组患者并发症发生情况及康复护理依从性。采用SPSS 26.0统计学软件进行数据分析，计量资料以均数 ± 标准差($\overline{x}\pm s$ )表示，组内比较采用配对t检验，组间比较采用独立样本t检验；计数资料以率(%)表示，采用χ²检验，P < 0.05为差异具有统计学意义。结果：干预前，两组患者FMA评分、BI评分比较，差异均无统计学意义(P > 0.05)，具有可比性。干预1个月、3个月后，两组患者FMA评分、BI评分均较干预前显著升高(P < 0.05)，且观察组FMA评分、BI评分均显著高于对照组，差异具有统计学意义(P < 0.05)；观察组患者康复护理依从性(90.48%)显著高于对照组(71.43%)，并发症发生率(9.52%)显著低于对照组(28.57%)，差异均具有统计学意义(P < 0.05)。结论：对脊髓损伤患者实施早期康复护理干预，可有效提高患者运动功能和日常生活活动能力，提升康复护理依从性，降低并发症发生率，促进患者早日康复，值得在临床广泛推广应用。

Abstract: Objective: To investigate the effect of early rehabilitation nursing intervention on motor function recovery in patients with spinal cord injury (SCI) and to provide a clinical basis for developing scientific and effective rehabilitation nursing protocols for SCI. Methods: A retrospective study was conducted on 42 SCI patients hospitalized in the Department of Rehabilitation Medicine and the Department of Orthopedics of our hospital from January 2022 to December 2025. Based on different nursing interventions, patients were divided into an observation group (n = 21) and a control group (n = 21). The control group received conventional rehabilitation nursing, including basic care, condition monitoring, routine health education, and simple functional exercise guidance. The observation group received early rehabilitation nursing intervention initiated within 48~72 hours after vital signs stabilized, in addition to the conventional care. This intervention included personalized measures such as positioning care, joint range of motion training, muscle strength training, balance and coordination training, and rehabilitation health education. Motor function (assessed using the Fugl-Meyer Assessment, FMA) and activities of daily living (assessed using the Barthel Index, BI) were compared between the two groups before the intervention, and at 1 and 3 months after the intervention. The incidence of complications and compliance with rehabilitation nursing were also recorded. SPSS 26.0 was used for statistical analysis. Measurement data are expressed as mean ± standard deviation ($\overline{x}\pm s$ ), with intra-group comparisons using paired t-tests and inter-group comparisons using independent sample t-tests. Count data are expressed as rates (%), analyzed using the chi-square (χ²) test. P < 0.05 was considered statistically significant. Results: Before the intervention, there were no significant differences in FMA and BI scores between the two groups (P > 0.05), indicating comparability. At 1 and 3 months after the intervention, both groups showed significant increases in FMA and BI scores compared with baseline (P < 0.05). Furthermore, the observation group had significantly higher FMA and BI scores than the control group at both time points, with statistically significant differences (P < 0.05). The observation group also demonstrated significantly higher compliance with rehabilitation nursing (90.48% vs. 71.43%) and a significantly lower complication rate (9.52% vs. 28.57%) compared with the control group, with statistically significant differences (P < 0.05). Conclusion: Implementing early rehabilitation nursing intervention for SCI patients can effectively enhance motor function and activities of daily living, improve compliance with rehabilitation nursing, reduce complication rates, and promote early recovery. It is worthy of widespread clinical application.