發(fā)布時(shí)間：2018-04-15 18:15

  本文選題：圍絕經(jīng)期 + 圍絕經(jīng)期綜合征��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:了解圍絕經(jīng)期是否是腰椎退變性疾病術(shù)后慢性腰痛的獨(dú)立危險(xiǎn)因素。方法:以2014年1月至2016年9月在我院住院確診為腰椎間盤(pán)突出癥或退變性腰椎管狹窄癥并進(jìn)行腰椎間盤(pán)髓核摘除、PLIF或TLIF手術(shù)的女性患者為研究對(duì)象。分別使用單因素Logistic回歸分析、多因素Logistic回歸分析及傾向得分匹配法(Propensity Score Analysis,PSM)對(duì)可能導(dǎo)致腰椎退變性疾病術(shù)后慢性腰痛的危險(xiǎn)因素進(jìn)行分析,尋找腰椎退變性疾病術(shù)后慢性腰痛的危險(xiǎn)因素及獨(dú)立危險(xiǎn)因素。納入研究的可能導(dǎo)致腰椎退變性疾病術(shù)后慢性腰痛的危險(xiǎn)因素包括年齡、BMI、基礎(chǔ)疾病、術(shù)前慢性腰痛、腰痛VAS疼痛評(píng)分、術(shù)前下肢疼痛時(shí)長(zhǎng)、腿痛VAS疼痛評(píng)分、術(shù)前腰椎JOA評(píng)分、手術(shù)方式、手術(shù)節(jié)段數(shù)目、具體手術(shù)節(jié)段、術(shù)者、出血量、圍絕經(jīng)期、圍絕經(jīng)期綜合征。數(shù)據(jù)使用SPSS 22.0進(jìn)行統(tǒng)計(jì)分析,p0.05認(rèn)為有統(tǒng)計(jì)學(xué)意義。結(jié)果:共178例患者符合納入標(biāo)準(zhǔn),隨訪過(guò)程中成功隨訪147例,31例失訪,隨訪率為82.58%,隨訪時(shí)間6-39個(gè)月,平均隨訪時(shí)間19.14±9.33個(gè)月。年齡19-77歲,平均年齡49.68±11.76歲。其中處在圍絕經(jīng)期者63例(42.86%),合并圍絕經(jīng)期綜合征者33例(22.45%)。合并慢性腰痛者53例(36.05%)。經(jīng)單因素Logistic分析發(fā)現(xiàn)腰椎退變性疾病術(shù)后慢性腰痛的危險(xiǎn)因素有BMI、術(shù)前慢性腰痛、手術(shù)時(shí)間、手術(shù)出血量、圍絕經(jīng)期及圍絕經(jīng)期綜合征(p0.05);經(jīng)多因素Logistic分析發(fā)現(xiàn)腰椎退變性疾病術(shù)后慢性腰痛獨(dú)立危險(xiǎn)因素有術(shù)前慢性腰痛、圍絕經(jīng)期及圍絕經(jīng)期綜合征;經(jīng)傾向得分匹配法(PSM)分析發(fā)現(xiàn)研究組(圍絕經(jīng)期組)與對(duì)照組(非圍絕經(jīng)期組)兩組間的慢性腰痛的發(fā)生率比較有統(tǒng)計(jì)學(xué)意義(p0.05);A組(合并圍絕經(jīng)期綜合征組)與B組(非合并圍絕經(jīng)期綜合征組)兩組間的慢性腰痛的發(fā)生率比較無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:1、對(duì)女性患者而言,圍絕經(jīng)期是腰椎退變性疾病術(shù)后慢性腰痛的獨(dú)立危險(xiǎn)因素。2、對(duì)女性患者而言,BMI、術(shù)前慢性腰痛、手術(shù)時(shí)間、手術(shù)出血量及圍絕經(jīng)期綜合征是腰椎退變性疾病術(shù)后慢性腰痛的危險(xiǎn)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 鹵9.33 months.The average age was 49.68 鹵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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李瑞霞;馬敏;肖喜榮;徐[?;顧超;何平;李斌;;40～55歲社區(qū)婦女圍絕經(jīng)期癥狀和焦慮、抑郁癥狀評(píng)分及相關(guān)因素分析[J];復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版);2017年01期

2 劉洋;賈宇濤;田融;孫天威;;腰椎術(shù)后綜合征的危險(xiǎn)因素及防治措施分析[J];解放軍醫(yī)藥雜志;2016年09期

3 唐少龍;葉招明;黃慶華;吳羅根;曹華敏;陳大勇;;腰椎終板Modic改變與腰椎退變的相關(guān)性研究[J];臨床骨科雜志;2015年04期

4 劉加元;魏東;葛行新;曹貞國(guó);佟磊;;腰腿痛患者M(jìn)odic改變的相關(guān)因素分布情況及分析[J];實(shí)用骨科雜志;2015年05期

5 鐘凱;曾祥華;洪愛(ài)軍;湯惠茹;;深圳市圍絕經(jīng)期女性常見(jiàn)癥狀及影響因素調(diào)查[J];護(hù)理研究;2015年08期

6 莊偉;莊汝杰;;下腰痛患者的Modic改變的流行病學(xué)分析[J];現(xiàn)代實(shí)用醫(yī)學(xué);2014年12期

7 張曉冬;王國(guó)柱;莊汝杰;;腰椎Modic改變面積與腰痛程度的關(guān)系[J];中醫(yī)正骨;2014年10期

8 王鵬;金格勒;楊毅;李忠偉;;腰椎術(shù)后綜合征危險(xiǎn)因素的分析[J];中國(guó)矯形外科雜志;2014年09期

9 馬學(xué)忠;王劍;馬全玉;梁明蘇;趙志彩;劉興華;;腰椎退行性疾患接受腰椎融合術(shù)后發(fā)生下腰痛和腰椎矢狀位序列的相關(guān)性研究[J];中國(guó)現(xiàn)代手術(shù)學(xué)雜志;2014年02期

10 張曉冬;王國(guó)柱;莊汝杰;;腰椎Modic改變的MRI定量與下腰痛相關(guān)性研究[J];中國(guó)骨傷;2014年03期

相關(guān)博士學(xué)位論文 前1條

1 陳國(guó)俊;Modic改變?cè)谟邢卵春蜔o(wú)下腰痛癥狀患者中的狀況分析[D];浙江大學(xué);2014年

相關(guān)碩士學(xué)位論文 前3條

1 馬瑞;腰椎間盤(pán)退行性疾病患者M(jìn)odic改變與性別、年齡、勞動(dòng)量、體重及下腰痛的關(guān)系[D];山東大學(xué);2012年

2 張亮;非隨機(jī)對(duì)照試驗(yàn)傾向得分區(qū)間匹配法的探索與應(yīng)用[D];第四軍醫(yī)大學(xué);2012年

3 李文選;腰椎Modic改變?cè)谘韧床±械姆植技跋嚓P(guān)因素的初步研究[D];吉林大學(xué);2012年

，

本文編號(hào)：1755230