腰椎退变性侧凸患者后路矫形融合术后健康相关生活质量影响因素分析  

Analysis of factors affecting postoperative health-related quality of life in patients with degenerative lumbar scoliosis

作　　者：邵为 林涛[1] 仲海燕 孟怡辰 马骁 姜横 马君 周许辉 SHAO Wei;LIN Tao;ZHONG Hai-yan;MENG Yi-chen;MA Xiao;JIANG Heng;MA Jun;ZHOU Xu-hui(Department of Spine Surgery,Changzheng Hospital Affiliated to Navy Military Medical University,Shanghai 200003,China;Department of Trauma,No.359 Hospital of PLA,Zhenjiang 212001,Jiangsu,China)

机构地区：[1]海军军医大学附属长征医院脊柱外科,上海200003 [2]中国人民解放军第359医院创伤外科,镇江212001

出　　处：《中国临床医学》2019年第2期260-264,共5页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨腰椎退变性侧凸患者后路矫形融合术后健康相关生活质量(health-related quality of life, HRQOL)的影响因素。方法:收集2011年7月至2015年7月接受后路矫形融合手术的退变性腰椎侧凸患者的临床数据和影像学资料。采用脊柱侧凸研究协会(Scoliosis Research Society,SRS)22项量表(SRS-22)评估患者术后HRQOL的改变情况,并对HRQOL的相关影响因素进行多因素logistic回归分析,以筛选其主要影响因素。结果:共221例患者纳入本研究。根据SRS-22评分,93例(42.1%)患者术后HRQOL评分为优秀,73例(33%)为改善,26例(11.8%)为无变化,29例(13.1%)为恶化。多因素logistic回归分析显示,患者年龄60～70岁(OR=2.512, 95%CI 1.231～4.262)、美国麻醉医师协会(American Society of Anesthesiologists,ASA)等级<3(OR=2.884, 95%CI 1.627～5.667)可能是术后HRQOL改善的预测因素,而并发症发生(OR=0.211, 95%CI 0.128～0.824)、术中截骨数量>2(OR=0.320, 95%CI 0.180～0.943)、远端融合至骶骨(OR=0.300, 95%CI 0.021～0.671)是术后HRQOL改善的不利因素。结论:影响老年退变性腰椎侧凸患者术后HRQOL改善的主要因素包括患者年龄、ASA分级、远端融合椎体水平、术中截骨数量及术后是否合并有并发症。Objective:To investigate the factors affecting health-related quality of life(HRQOL)in patients with degenerative lumbar scoliosis following posterior spinal instrumentation and fusion.Methods:Clinical data and demographics of patients who underwent posterior spinal instrumentation and fusion for degenerative lumbar scoliosis from July 2011 to July 2015 were collected,the Scoliosis Research Society(SRS)-22 scale was used to evaluate the changes of postoperative HRQOL,and multivariate logistic regression analysis was performed on the relevant factors of HRQOL to screen the main influencing factors.Results:A total of 221 patients were included in the study.Among them,93(42.1%)patients had excellent recovery,73(33%)patients had improvement,26(11.8%)patients had no change,and 29(13.1%)patients had worsening.According to multivariate logistic regression analysis:age between 60 and 70 years(OR=2.512,95%CI 1.231-4.262),American Society of Anesthesiologists(ASA)grade<3(OR=2.884,95%CI 1.627-5.667)were predictors of postoperative HRQOL improvement.Presence of complications(OR=0.211,95%CI 0.128-0.824),number of osteotomy>2(OR=0.320,95%CI 0.180-0.943),and fusion to the sacral(OR=0.300,95%CI 0.021-0.671)has negative impact on the HRQOL recovery.Conclusions:The main factors affecting the improvement of postoperative HRQOL in elderly patients with degenerative lumbar scoliosis were age,ASA grade,level of distal fusion vertebrae,number of osteotomy,and incidence of complications.

关 键 词：退变性脊柱侧弯 老年 健康相关生活质量 

分 类 号：R681.57[医药卫生—骨科学]