退行性腰椎管狭窄合并腰椎失稳症术后疼痛发生的非治疗因素研究

发布时间：2018-05-16 21:30

本文选题：腰椎管狭窄症 + 腰椎术后综合征　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:探讨退行性腰椎管狭窄合并腰椎失稳症术后疼痛发生的危险因素,以期更好的预测腰椎术后综合征的发生。方法:回顾分析2012年11月至2015年6月,在我院脊柱外科住院,根据患者症状、体征及影像学检查明确诊断为单/双节段退行性腰椎管狭窄合并腰椎失稳症,并行腰椎减压及内固定的手术病人,手术后进行随访,随访时间6-35个月,平均19.7个月,根据腰椎术后综合征的定义,判定出腰椎术后疼痛的患者,并回顾分析患者的临床资料,对可能发生腰椎术后疼痛的可能危险因素进行二分类非条件单因素和多因素Logistic回归分析,探讨其相关因素。结果:共计纳入术后患者259例,获得随访242例,其中符合腰椎术后疼痛患者18例,不符合患者224例。整理两组临床资料,单因素结果分析显示:(1)性别、年龄、吸烟史、饮酒史、高血压病、糖尿病、定量CT值、单双节段等因素在患者术后疼痛的发生上无统计学意义(P0.05);(2)病程因素在患者术后疼痛的发生上有统计学意义(P0.05)。多因素结果分析同样显示:病程因素在患者术后疼痛的发生上有统计学意义(P0.05),且病程12月的患者发生腰椎术后综合征的风险相对较高。结论:退行性腰椎管狭窄合并腰椎失稳症术后疼痛发生的相关危险因素是病程,病程越久,发生术后疼痛的几率越高。
[Abstract]:Objective: to investigate the risk factors of postoperative pain in degenerative lumbar spinal stenosis combined with lumbar instability in order to predict the occurrence of lumbar postoperative syndrome. Methods: from November 2012 to June 2015, the patients were hospitalized in spinal surgery in our hospital. According to the symptoms, signs and imaging examination, they were diagnosed as single / double degenerative lumbar spinal stenosis with lumbar instability. Patients undergoing lumbar decompression and internal fixation were followed up for 6-35 months with an average of 19.7 months. According to the definition of lumbar postoperative syndrome, the patients with postoperative pain were identified, and the clinical data of the patients were analyzed retrospectively. The possible risk factors of lumbar postoperative pain were analyzed by Logistic regression analysis. Results: a total of 259 patients were included in the study. 242 cases were followed up, including 18 cases of postoperative pain and 224 cases of nonconformity. Univariate analysis showed sex, age, smoking history, drinking history, hypertension, diabetes, quantitative CT value. There was no significant difference in the occurrence of postoperative pain between single and double segments. The multivariate analysis also showed that there was a significant difference in the incidence of postoperative pain in patients with disease course, and the risk of lumbar postoperative syndrome was higher in patients with 12 months of disease course. Conclusion: the risk factor of postoperative pain of degenerative lumbar spinal stenosis combined with lumbar instability is the course of disease. The longer the course of disease, the higher the incidence of postoperative pain.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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