中国患者全膝关节置换术后运动障碍的发生率及相关危险因素分析  

Incidence and risk factors of dyskinesia after total knee arthroplasty in Chinese patients

作　　者：朱旭[1] 张林 赵增同 高丽[1] 张亚奎[1] 曾纪洲[1] ZHU Xu;ZHANG Lin;ZHAO Zengtong;GAO Li;ZHANG Yakui;ZENG Jizhou(Department of Joint and Sports Medicine,Beijing Luhe hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院关节与运动医学科,北京101149

出　　处：《中华骨与关节外科杂志》2021年第2期116-120,共5页Chinese Journal of Bone and Joint Surgery

基　　金：北京市通州区科技计划(KJ2017CX043-10);北京市通州区高层次人才发展支持计划领军人才资助项目(YHLD2017009)。

摘　　要：背景:心理因素(如害怕疼痛和恐动症)所致的运动障碍严重影响全膝关节置换术(TKA)患者的术后康复,在影响治疗结果方面与抑郁症具有协同相互的作用。目的:探讨中国患者TKA后运动障碍的发生率及相关危险因素。方法:回顾性分析2011年1月至2018年12月接受单侧TKA的862例患者的临床资料,采用简化中文版恐动症评分表(TSK)、膝关节自我效能量表(K-SES)、数字评定量表(NRS)、简易应对方式问卷(SCSQ)和社会支持评定量表(SSRS)用于评估恐动症、自我效能、疼痛强度、应对方式和社会支持。采用多变量逻辑回归分析确定TKA术后运动障碍的危险因素。结果:862例患者根据TSK结果分为运动障碍组210例,TSK>37分,发生了TKA术后运动障碍;无运动障碍组652例,TSK≤37分,未发生TKA术后运动障碍。多因素Logistic回归分析显示年龄较大(≥76岁)、教育程度较低、消极应对方式、社会支持较少、自我效能较低和更大的疼痛强度是TKA术后运动障碍的独立危险因素。结论:TKA患者术后出现运动障碍的发生率较高。年龄较大(≥76岁)、教育程度较低、消极应对方式、社会支持较少、自我效能较低和更大的疼痛强度与TKA患者术后出现运动障碍密切相关。Background:Dyskinesia caused by psychological factors like fear of pain and phobia seriously affects the postop⁃erative rehabilitation of patients with total knee arthroplasty(TKA),and has a synergistic interaction with depression in influ⁃encing the treatment outcome.Objective:To investigate the incidence of dyskinesia and the related risk factors in total knee arthroplasty(TKA)in Chinese patients.Methods:A total of 862 patients who underwent TKA in our department from January 2011 to December 2018 were selected.The simplified Chinese version of the Taka scale for kinesiophobia(SC-TSK),knee self-efficacy scale(K-SES),numerical rating scale(NRS),simplified coping style questionnaire(SCSQ)and social support rat⁃ing scale(SSRS)were used to assess dysphoria,self-efficacy,pain intensity,coping style,and social support.Multivariate lo⁃gistic regression analysis was used to determine risk factors for dyskinesia after TKA.Results:All participants were divided to dyskinesia group(n=210)with TSK>37 and non-dyskinesia group(n=652)with TSK≤37.Multivariate logistic regression anal⁃ysis showed that older age,lower education,negative coping style,less social support,lower self-efficacy and greater pain in⁃tensity were the independent risk factors for dyskinesia after TKA.Conclusions:The incidence of postoperative dyskinesia in patients undergoing TKA is high.Older age(≥76 years),lower education,negative coping style,less social support,lower selfefficacy and greater pain intensity are associated with postoperative dyskinesia in patients undergoing TKA.

关 键 词：运动障碍 发病率 危险因素 全膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]