腰椎滑脱术后患者抑郁、焦虑的改善及对预后的影响

发布时间：2018-05-24 09:12

本文选题：腰椎滑脱 + 焦虑　；参考：《中国矫形外科杂志》2017年01期

【摘要】：[目的]观察腰椎滑脱患者行腰椎滑脱切开复位融合术后抑郁、焦虑的改善情况,探讨腰椎滑脱患者术前抑郁焦虑对预后的影响。[方法]回顾性分析2010年1月~2015年1月于本院行腰椎滑脱(I度)切开复位融合术的125例患者术前术后抑郁、焦虑心理状况。于术前及术后1周、3个月、6个月、1年及末次随访时采用Zung抑郁自评量表(SDS)和Zung焦虑自评量表(SAS)评估患者负性心理,腰背疼痛视觉模拟评分(BP-VAS)、腿部疼痛(LP-VAS)及日本骨科学会(JOA)评分评估神经功能,术后返回工作时间、SF-36量表评估生活质量,以单因素相关分析对结果进行统计处理。[结果]所有患者临床症状及神经功能都有所改善,18例患者术前出现明显的抑郁,37例患者出现焦虑;术后患者SDS及SAS评分均较术前改善,焦虑改善程度有统计学意义,抑郁改善程度无统计学意义。末次随访时患者抑郁及焦虑评分与VAS、术后返回工作时间和SF-36评分显著相关,但与JOA评分无显著相关。[结论]部分腰椎滑脱患者术前存在抑郁和焦虑,腰椎滑脱切开复位融合术可以部分改善这种负性心理,患者的负性心理对其预后有负性作用,术前抑郁及焦虑程度是一项关于腰椎滑脱切开复位融合术的患者术后返回工作时间的独立预估因素。
[Abstract]:[objective] to observe the improvement of depression and anxiety after open reduction and fusion of lumbar spondylolisthesis, and to explore the influence of depression and anxiety on the prognosis of patients with lumbar spondylolisthesis. [methods] 125 patients who underwent lumbar spondylolisthesis with open reduction and fusion from January 2010 to January 2015 were analyzed retrospectively. Before and 1 week, 3 months, 6 months, 1 year and the last follow-up, the patients were assessed with Zung self rating Depression scale (Zung) and Zung anxiety scale (SAS). Visual analogue score of lumbar and back pain (BP-VASA), leg pain (LP-VASS) and Japanese orthopedic society (JOAA) score were used to evaluate the neurological function, and the time of return to work after operation was evaluated by SF-36 scale. The results were statistically analyzed by single factor correlation analysis. [results] the clinical symptoms and neurological function of all the patients were improved. There were 37 patients with depression and 37 patients with anxiety before operation, the scores of SDS and SAS were improved after operation, and the degree of anxiety improvement was statistically significant. The improvement of depression was not statistically significant. At the last follow-up, depression and anxiety scores were significantly correlated with vas, return working time and SF-36 score, but had no significant correlation with JOA score. [conclusion] some patients with lumbar spondylolisthesis have depression and anxiety before operation. Open reduction and fusion of lumbar spondylolisthesis can partially improve the negative psychology. Preoperative depression and anxiety are an independent predictor of the return time of patients with lumbar spondylolisthesis after open reduction and fusion.
【作者单位】：南京军区福州总医院骨科;
【分类号】：R687.3;R749

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