围绝经期与腰椎退变性疾病术后慢性腰痛的关联性研究

发布时间：2018-04-15 18:15

本文选题：围绝经期 + 围绝经期综合征　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:了解围绝经期是否是腰椎退变性疾病术后慢性腰痛的独立危险因素。方法:以2014年1月至2016年9月在我院住院确诊为腰椎间盘突出症或退变性腰椎管狭窄症并进行腰椎间盘髓核摘除、PLIF或TLIF手术的女性患者为研究对象。分别使用单因素Logistic回归分析、多因素Logistic回归分析及倾向得分匹配法(Propensity Score Analysis,PSM)对可能导致腰椎退变性疾病术后慢性腰痛的危险因素进行分析,寻找腰椎退变性疾病术后慢性腰痛的危险因素及独立危险因素。纳入研究的可能导致腰椎退变性疾病术后慢性腰痛的危险因素包括年龄、BMI、基础疾病、术前慢性腰痛、腰痛VAS疼痛评分、术前下肢疼痛时长、腿痛VAS疼痛评分、术前腰椎JOA评分、手术方式、手术节段数目、具体手术节段、术者、出血量、围绝经期、围绝经期综合征。数据使用SPSS 22.0进行统计分析,p0.05认为有统计学意义。结果:共178例患者符合纳入标准,随访过程中成功随访147例,31例失访,随访率为82.58%,随访时间6-39个月,平均随访时间19.14±9.33个月。年龄19-77岁,平均年龄49.68±11.76岁。其中处在围绝经期者63例(42.86%),合并围绝经期综合征者33例(22.45%)。合并慢性腰痛者53例(36.05%)。经单因素Logistic分析发现腰椎退变性疾病术后慢性腰痛的危险因素有BMI、术前慢性腰痛、手术时间、手术出血量、围绝经期及围绝经期综合征(p0.05);经多因素Logistic分析发现腰椎退变性疾病术后慢性腰痛独立危险因素有术前慢性腰痛、围绝经期及围绝经期综合征;经倾向得分匹配法(PSM)分析发现研究组(围绝经期组)与对照组(非围绝经期组)两组间的慢性腰痛的发生率比较有统计学意义(p0.05);A组(合并围绝经期综合征组)与B组(非合并围绝经期综合征组)两组间的慢性腰痛的发生率比较无统计学意义(p0.05)。结论:1、对女性患者而言,围绝经期是腰椎退变性疾病术后慢性腰痛的独立危险因素。2、对女性患者而言,BMI、术前慢性腰痛、手术时间、手术出血量及围绝经期综合征是腰椎退变性疾病术后慢性腰痛的危险因素。
[Abstract]:Objective: to investigate whether perimenopausal period is an independent risk factor for chronic low back pain after lumbar degenerative disease.Methods: from January 2014 to September 2016, female patients with lumbar disc herniation or degenerative lumbar spinal stenosis who underwent PLIF or TLIF surgery were studied.Univariate Logistic regression analysis, multivariate Logistic regression analysis and propensity Score analysis were used to analyze the risk factors of chronic low back pain after lumbar degenerative disease.To find out the risk factors and independent risk factors of chronic low back pain after lumbar degenerative disease.The risk factors that may lead to chronic low back pain after lumbar degenerative disease included age BMIs, underlying diseases, preoperative chronic low back pain, low back pain VAS pain score, preoperative lower limb pain duration, leg pain VAS pain score, preoperative lumbar JOA score.Mode of operation, number of segments, specific segments, operator, bleeding volume, peri-menopausal, peri-menopausal syndrome.The data were statistically analyzed using SPSS 22. 0.Results: a total of 178 patients met the inclusion criteria. In the course of follow-up, 147 cases were followed up successfully, 31 cases were lost, the follow-up rate was 82.58, the follow-up time was 6-39 months, the average follow-up time was 19.14 卤9.33 months.The average age was 49.68 卤11.76 years.Among them, 63 cases were in peri-menopausal period and 33 cases were complicated with peri-menopausal syndrome.There were 53 cases with chronic low back pain.Univariate Logistic analysis showed that the risk factors of chronic low back pain after lumbar degenerative disease were BMIs, preoperative chronic low back pain, operative time, and blood loss.Multiple factor Logistic analysis showed that the independent risk factors of chronic low back pain after lumbar degenerative disease were preoperative chronic low back pain, peri-menopausal and peri-menopausal syndrome.The incidence of chronic low back pain in study group (perimenopausal group) and control group (non-menopausal group) was significantly higher than that in group A (combined with menopausal syndrome).There was no significant difference in the incidence of chronic low back pain between group B (non-menopausal syndrome group) and two groups (p 0. 05).Conclusion: for female patients, peri-menopausal period is an independent risk factor of chronic low back pain after lumbar degenerative disease.Surgical bleeding and peri-menopausal syndrome are risk factors for chronic low back pain after lumbar degenerative disease.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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