青少年特发性脊柱侧凸患者术后生活质量的影响因素分析  

Influencing factors for postoperative quality of life in patients with adolescent idiopathic scoliosis

作　　者：肖曜升 马向阳[2] 杨进城[2] 邱锋[2] 周鑫[2] 胡海生[2] 

机构地区：[1]南方医科大学研究生院,广州市510000 [2]广州军区广州总医院骨科,广州市510010

出　　处：《中国矫形外科杂志》2016年第15期1403-1408,共6页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81171768);广东省自然科学基金项目(编号:2014A030313600)

摘　　要：[目的]分析各因素对青少年特发性脊柱侧凸患者术后生活质量的综合影响,为提高患者生活质量提供参考。[方法]选择2011年1月~2015年1月在本院手术的青少年特发性脊柱侧凸患者79例,之前均未接受任何治疗,详细统计患者性别、年龄、居住地、胸弯Cobb角、腰弯Cobb角、冠状面C_7铅垂线与骶骨正中线距离、矢状面C_7铅垂线与骶骨后上角距离、顶椎旋转度、双肩平衡等,采用SRS-30生活质量问卷进行评估,而后用多重线性回归模型预测各因素与青少年特发性脊柱侧凸患者术后生活质量的相关性。[结果]患者术后均获得不同程度改善,术后胸弯Cobb角平均20.7°,腰弯Cobb角平均12.8°,双肩高度差平均6.8 mm,C_7PL-CSVL平均13.7 mm,SVA平均22.9 mm,术后患者生活质量总分128.3分,各维度平均得分分别为疼痛（4.53）、心理（4.46）、功能/活动（3.73）、自我形象（4.28）、满意度（4.45）。男性患者在功能/活动维度（P=0.05）及满意度（P=0.037）上得分显著高于女性患者,城乡患者间得分无明显差异。[结论]不同影响因素对SRS-30问卷各个维度的影响权重各异,青少年特发性脊柱侧凸患者术后的生活质量是各个因素综合作用的结果。[ Objective ] To investigate the comprehensive influence of various factors on postoperative quality of life （QOL） in patients with adolescent idiopathic seoliosis, and to provide a basis for the improvement in QOL. [ Methods] A total of 79 previously untreated patients with adolescent idiopathic seoliosis who underwent surgery in our hospital from January 2011 to January 2015 were selected. The sex, age, place of residence, thoraeie and lumbar Cobb angles, distance between the C7 plumb line and the central sacral vertical line （ CvPL - CSVL）, sagittal vertical axis （ SVA）, apical vertebral rotation, and balance between the shoulders were recorded, and the Seoliosis Research Society Health - Related Quality of Life （ SRS - 30） questionnaire was applied to evaluate the QOL. The multiple linear regression model was applied to predict the correlation be- tween various factors and postoperative QOL in the patients with adolescent idiopathic seoliosis. [ Results ] After surgery, the patients had varying degrees of improvement, with a mean thoracic Cobb angle of 20. 7~, a mean lumbar Cobb angle of 12. 8~, a mean shoulder height difference of 6. 8 ram, a mean CvPL - CSVL of 13.7 ram, and a mean SVA of 22. 9 ram. The total score of postoperative QOL was 128.3, and the mean scores of pain, mental health, function/activity, serf - image/appearance, and satisfaction were 4. 53, 4. 46, 3.73, 4. 28, and 4.45, respectively. The male patients had significantly higher scores on function/activity and satisfaction subscales than the female patients （ P = 0. 05 and 0. 037 ）, and the scores showed no significant differences between urban and rural patients. [ Conclusion ] Various factors have different effects on each subscale of SRS - 30 questionnaire, and the combined action of these factors influences the postoperative QOL in patients with adolescent idiopathic scoli- osis.

关 键 词：青少年 特发性脊柱侧凸 SRS-30 生活质量 术后 影响因素 

分 类 号：R687.3[医药卫生—骨科学]