MED治疗腰椎间盘突出症的生活质量的随访观察

发布时间：2018-04-15 13:10

本文选题：MED + 腰椎间盘突出症　；参考：《石河子大学》2015年硕士论文

【摘要】：目的:本次研究通过对腰椎间盘突出症患者行MED手术治疗后与健康相关的生活质量调查来了解患者疾病预后状态,客观的评价腰椎间盘突出症术后的疗效,进一步分析生活质量的影响因素,以期为脊柱微创手术治疗提供参考。方法:选自2011年09月-2013年09月石河子大学医学院第一附属医院骨一科诊断为“腰椎间盘突出症”的住院患者,入选患者为行MED治疗的患者,共76例。记录患者一般信息及疾病相关资料。应用SF-36中文版生活质量评价,随访观察并给予评分。统计方法采用t检验,Kruscal-Walis秩和检验、方差分析、相关分析和多元回归分析等。使用SPSS17.0处理数据。结果:1.腰椎间盘突出症患者生活质量SF-36各维度评分均明显低于一般人群常模,术后在各维度的评分均提升。2.对MED术后患者生活质量独立影响因素组间比较发现,年龄方面除去在精神健康维度中老年组平均得分高于青年组,但统计学无差异(P0.05),其他维度平均值青年组大于中老年组,在生理机能,生理职能,躯体疼痛,总体健康以及活力方面统计学存在差异;男性患者在大部分维度上得分大于女性患者,在活力维度上差异有意义(P0.05);脑力劳动组患者在生理机能、主观总体健康、精神健康以及社会职能维度上与退休人群比较存在差异;初中以下文化程度患者与大学组患者在生理机能、躯体疼痛、社会职能精神健康方面相比,得分明显低,初中组与高中组相比在躯体疼痛方面存在差异,高中组与大学组相比,无明显差异;病程在6月以内患者术后生活质量在各维度上均与大于6月病程患者的得分在生理机能、躯体疼痛方面相比,统计学存在差异。病程6月至1年组与大于1年病程组比较得分在各维度上无明显差异;吸烟对患者生活质量的影响表现各维度不吸烟组得分均高于吸烟组,尤其在躯体疼痛和生理职能维度上差异明显,有统计学意义;腰背肌功能患者在生理机能,生理职能,躯体疼痛,总体健康维度上明显高于未坚持做腰背肌功能训练患者统计学差异明显。突出类型及节段对患者预后生活质量影响比较无统计学意义。3.MED术后生活质量与相关因素多元回归分析得出,年龄、腰背肌功能锻炼、吸烟在患者生理评价中起主要影响因素,职业及文化程度在主观指标维度上起主要影响因素。结论:1.腰椎间盘突出症患者生活质量各维度得分均明显低于一般常模。MED术后1年随访各维度得分均提高,尤其在生理机能,生理职能,躯体疼痛,社会职能方面改善明显。2.初步探讨了人口学因素、疾病相关因素与生活质量的相关性,年龄、职业、吸烟、病程、腰背肌功能锻炼是影响患者生活质量的因素。3.年龄、吸烟、腰背肌功能锻炼时影响患者生理健康的主要因素,文化程度是影响患者精神健康的主要因素。
[Abstract]:Objective: to investigate the health related quality of life (QOL) of patients with lumbar disc herniation (LIDP) after MED operation, and to evaluate objectively the curative effect of LIDP.To further analyze the influencing factors of quality of life in order to provide reference for minimally invasive spinal surgery.Methods: from September 2011 to September 2013, 76 patients with lumbar disc herniation were selected from the first affiliated Hospital of Shihezi University Medical College. 76 patients were selected as patients treated with MED.Record patient general information and disease related information.The Chinese version of SF-36 was used to evaluate the quality of life.The statistical methods were t-test Kruscal-Walis rank sum test, variance analysis, correlation analysis and multivariate regression analysis.Use SPSS17.0 to process data.The result is 1: 1.The quality of life (SF-36) scores of patients with lumbar disc herniation were significantly lower than that of the general population norm, and the scores in each dimension were improved by 0.2.Compared with the independent factors of quality of life after MED, it was found that the average score of the aged group was higher than that of the young group except in the mental health dimension, but there was no statistical difference (P 0.05), but the other dimension average value in the young group was higher than that in the middle and old group.There were statistical differences in physiological function, physiological function, physical pain, overall health and vitality; male patients scored more in most dimensions than women.There were significant differences in the dimension of vitality between the patients of mental labor group and the retired group in the aspects of physiological function, subjective general health, mental health and social function.The scores of physical function, physical pain, social function and mental health were significantly lower in patients with lower education level than those in college group. There were differences in physical pain between junior high school group and senior high school group, and between senior high school group and university group.There was no significant difference in the quality of life between the patients with disease course within 6 months and the scores of patients with more than 6 months course of disease in terms of physiological function and somatic pain.There was no significant difference in the scores between the patients with disease course from 6 months to 1 year and those with more than 1 year course of disease, and the effect of smoking on the quality of life of the patients was higher than that of the smoking group in all dimensions.Especially in the dimensions of somatic pain and physiological function, there are significant differences in the physical function, physiological function and somatic pain in patients with lumbar dorsal muscle function.The overall health dimension was significantly higher than that of the patients who did not insist on lumbar dorsalis muscle function training.3. Multiple regression analysis showed that age, psoas muscle function exercise and smoking play a major role in the physiological evaluation of patients. 3. There was no significant difference in the prognostic quality of life between patients with protruding type and segment. 3. The multiple regression analysis showed that age, psoas muscle function exercise and smoking played a major role in the physiological evaluation of patients.Occupation and education level are the main influencing factors in subjective index dimension.Conclusion 1.The scores of all dimensions of quality of life in patients with lumbar disc herniation were significantly lower than those in the general norm. MED 1 year follow-up, especially in physiological function, physiological function, physical pain, social function. 2.The demographic factors, disease related factors and quality of life (QOL), age, occupation, smoking, course of disease, and psoas muscle function exercise were discussed.Age, smoking, and psoas muscle function exercise were the main factors affecting the patients' physical health, and the education level was the main factor affecting the patients' mental health.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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