腰椎管狭窄症患者手术后不良心理因素与预后结局的关系  

Relationship between postoperative depression and anxiety symptoms and function after lumbar spinal stenosis surgery

作　　者：温建伟 吴赵 张文奎 WEN Jian-wei;WU Zhao;ZHANG Wen-kui(Department of Orthopedics,Yicheng County Hospital of Traditional Chinese Medicine,Yicheng,Shanxi 043500,China)

机构地区：[1]翼城县中医医院骨伤科,山西翼城043500

出　　处：《颈腰痛杂志》2023年第6期926-929,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨退行性腰椎管狭窄症(degenerative lumbar spinal stenosis,DLSS)患者手术后抑郁和焦虑症状与患者功能恢复的关系。方法选择2019年7月~2021年6月在本院接受手术治疗的DLSS患者113例作为研究对象,采用医院焦虑抑郁量表(hospital anxiety and depression Scale,HADS)的焦虑(hospital anxiety and depression Scale-anxiety,HADS-A)和抑郁(hospital anxiety and depression Scale-depression,HADS-D)2个子量表评估患者在术前、术后1个月时的焦虑和抑郁状态,采用腰椎管狭窄症量表(swiss spinal stenosis measure,SSS)评估患者术前、术后6个月、术后12个月时症状和功能情况;平衡混杂因素后,观察术前、术后1个月时HADS-A和HADS-D与术后12个月时SSS症状和SSS功能改善情况的关系。结果术前焦虑阳性率为47.79%;抑郁阳性率为36.28%。术后1个月时,患者HADS-A得分0~14分,中位得分5分;HADS-D得分0~13分,中位得分5分;焦虑阳性患者34例,占30.09%;抑郁阳性患者26例,占23.01%。术后1个月时,焦虑和抑郁阳性率均显著低于术前,差异均有统计学意义(P=0.006、0.029)。术后6个月和12个月时,患者SSS症状评分和SSS功能评分均较术前显著降低(P<0.05);术前抑郁、术前焦虑、术后抑郁、术后焦虑阳性患者在术前、术后6个月、术后12个月时的SSS症状评分和SSS功能评分均显著高于阴性患者(P<0.05)。平衡混杂因素后,术后焦虑和术后抑郁与术后12个月时SSS症状和SSS功能评分均呈正相关(P<0.05),术前焦虑和术前抑郁与术后12个月时SSS症状和SSS功能不存在显著相关性(P>0.05)。结论DLSS患者术后抑郁和焦虑状态与患者术后12个月时的症状和功能改善情况存在相关性,应考虑早期给予心理干预。Objective To investigate the relationship between postoperative depression and anxiety symptoms and functional recovery of patients with degenerative lumbar spinal stenosis(DLSS).Methods Altogether 113 patients with DLSS who underwent surgery in our hospital from July 2019 to June 2021 were selected as the research objects.Anxiety(HADS-A)and depression(HADS-D)subscales of hospital anxiety and depression scale(HADS)were used to evaluate the anxiety and depression status of patients before and one month after operation.Lumbar spinal stenosis scale(SSS)was used to evaluate the symptoms and function of patients at baseline,6 months and 12 months after operation,and the relationship between HADS-A and HADS-D before and one month after operation and SSS symptoms and SSS function 12 months after operation was observed.Results The positive rate of preoperative anxiety was 47.79%,and the positive rate of depression was 36.28%.The positive rate of anxiety one month after operation was 30.09%,and the positive rate of depression was 23.01%.The positive rates of anxiety and depression one month after operation were lower than those before operation,and the difference was statistically significant(P=0.006,0.029).Six and twelve months after operation,the SSS symptom score and SSS function score were significantly lower than those at baseline(P<0.05).The SSS symptoms and SSS function of patients with preoperative depression,preoperative anxiety,postoperative depression and postoperative anxiety were higher than those of negative patients at baseline,6 months and 12 months after operation(P<0.05).After balancing confounding factors,postoperative anxiety and depression were positively correlated with SSS symptoms and SSS function scores 12 months after operation(P<0.05).Preoperative anxiety and depression were not significantly correlated with SSS symptoms and SSS function 12 months after operation(P>0.05).Conclusion There is a correlation between postoperative depression and anxiety in patients with DLSS and their symptoms and fu

关 键 词：腰椎管狭窄症 腰椎减压术 抑郁 焦虑 相关性 

分 类 号：R681.57[医药卫生—骨科学]