腰臀比对腰椎退行性疾病术后疗效的影响  

Effects of waist-to-hip ratio on postoperative outcomes of lumbar degenerative diseases

作　　者：席金涛 鲁齐林 王小阵 汪洋 吕鹏 汪雄伟 陈龙[1] 石震 竺义亮 XI Jintao;LU Qilin;WANG Xiaozhen;WANG Yang;LYU Peng;WANG Xiongwei;CHEN Long;SHI Zhen;ZHU Yiliang(Wuhan Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine(The Affiliated Hospital of Wuhan Sports University),Wuhan 430060,Hubei,China)

机构地区：[1]武汉中西医结合骨科医院/武汉体育学院附属医院,湖北武汉430060

出　　处：《中医正骨》2024年第4期11-14,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨腰臀比对腰椎退行性疾病术后疗效的影响。方法:回顾性分析1220例腰椎退行性疾病患者的病例资料,其中低腰臀比组102例(男性腰臀比<0.85,女性腰臀比<0.75)、正常腰臀比组705例(男性腰臀比为0.85~0.9,女性腰臀比为0.75~0.8)、高腰臀比组413例(男性腰臀比>0.9,女性腰臀比>0.8)。比较3组患者的手术时间、术中出血量、术后1年Oswestry功能障碍指数(Oswestry disability index,ODI)及腰背部、臀部、腿部、足部疼痛数字评分。结果:(1)一般结果。3组患者的手术时间、术中出血量比较,组间差异均有统计学意义[(118.8±25.6)min,(125.5±18.8)min,(139.3±26.6)min,F=11.238,P=0.001;(125.4±20.6)mL,(140.9±28.6)mL,(188.2±31.6)mL,F=14.262,P=0.035]。高腰臀比组患者手术时间长于正常腰臀比组和低腰臀比组(P=0.001,P=0.001),术中出血量多于正常腰臀比组和低腰臀比组(P=0.001,P=0.001);正常腰臀比组患者的手术时间、术中出血量和低腰臀比组比较,组间差异均无统计学意义(P=0.136,P=0.117)。(2)术后1年疼痛数字评分。3组患者术后1年腰背部、臀部、腿部疼痛数字评分比较,组间差异均有统计学意义[(2.60±0.96)分,(2.17±0.84)分,(3.27±1.10)分,F=17.901,P=0.036;(1.45±0.52)分,(1.49±0.50)分,(2.78±0.85)分,F=54.421,P=0.001;(2.09±0.70)分,(2.13±0.98)分,(2.80±1.16)分,F=6.239,P=0.003];足部疼痛数字评分比较,差异无统计学意义[(1.55±0.52)分,(1.39±0.49)分,(1.29±0.46)分,F=1.731,P=0.182]。高腰臀比组患者术后1年腰背部、臀部、腿部疼痛数字评分均高于低腰臀比组和正常腰臀比组(P=0.045,P=0.001;P=0.047,P=0.003;P=0.029,P=0.001),正常腰臀比组患者术后1年腰背部、臀部、腿部疼痛数字评分和低腰臀比组比较,组间差异均无统计学意义(P=0.176,P=0.291,P=0.716)。(3)术后1年ODI。3组患者术后1年ODI比较,差异有统计学意义[(19.40±6.52)%,(12.59±6.81)%,(24.28±9.83)%,F=30.502,P=0.001]。高腰臀比组患者术�Objective:To explore the effects of waist-to-hip ratio(WHR)on postoperative outcomes of lumbar degenerative diseases(LDDs).Methods:The medical records of 1220 patients with LDDs were retrospectively analyzed.The patients were divided into 3 groups according to the WHR,the ones with the WHR of<0.85 in males and<0.75 in females were assigned into the low WHR group(102 cases),the ones with the WHR ranged from 0.85 to 0.9 in males,0.75 to 0.8 in females into the normal WHR group(705 cases),and the ones with the WHR of>0.9 in males and>0.8 in females into the high WHR group(413 cases).The operative time,intraoperative blood loss,Oswestry disability index(ODI)as well as the lower back,hip,leg and foot pain numeric rating scale(NRS)scores evaluated at postoperative month 12 were compared among the 3 groups.Results:①There was statistical difference in the operative time and intraoperative blood loss among the 3 groups(118.8±25.6,125.5±18.8,139.3±26.6 minutes,F=11.238,P=0.001;125.4±20.6,140.9±28.6,188.2±31.6 mL,F=14.262,P=0.035).The operative time was longer,and the intraoperative blood loss was more in high WHR group compared to normal WHR group and low WHR group(P=0.001,P=0.001;P=0.001,P=0.001),while,the comparison of operative time and intraoperative blood loss between normal WHR group and low WHR group revealed no significant differences(P=0.136,P=0.117).②The difference was statistically significant in lower back,hip and leg pain NRS scores evaluated at postoperative month 12,while,not statistically significant in foot pain NRS score evaluated at postoperative month 12 among the 3 groups(2.60±0.96,2.17±0.84,3.27±1.10 points,F=17.901,P=0.036;1.45±0.52,1.49±0.50,2.78±0.85 points,F=54.421,P=0.001;2.09±0.70,2.13±0.98,2.80±1.16 points,F=6.239,P=0.003;1.55±0.52,1.39±0.49,1.29±0.46 points,F=1.731,P=0.182).The lower back,hip and leg pain NRS scores evaluated at postoperative month 12 were higher in high WHR group compared to low WHR group and normal WHR group(P=0.045,P=0.001;P=0.047,P=0.003;P=0.029,P=0.0

关 键 词：腰椎 椎间盘退化 椎间盘移位 椎管狭窄 脊椎滑脱 肥胖症 腰髋比率 

分 类 号：R687.3[医药卫生—骨科学]