發(fā)布時間：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》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)后慢性腰痛的獨立危險因素。方法:以2014年1月至2016年9月在我院住院確診為腰椎間盤突出癥或退變性腰椎管狹窄癥并進行腰椎間盤髓核摘除、PLIF或TLIF手術(shù)的女性患者為研究對象。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)對可能導致腰椎退變性疾病術(shù)后慢性腰痛的危險因素進行分析,尋找腰椎退變性疾病術(shù)后慢性腰痛的危險因素及獨立危險因素。納入研究的可能導致腰椎退變性疾病術(shù)后慢性腰痛的危險因素包括年齡、BMI、基礎(chǔ)疾病、術(shù)前慢性腰痛、腰痛VAS疼痛評分、術(shù)前下肢疼痛時長、腿痛VAS疼痛評分、術(shù)前腰椎JOA評分、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進行統(tǒng)計分析,p0.05認為有統(tǒng)計學意義。結(jié)果:共178例患者符合納入標準,隨訪過程中成功隨訪147例,31例失訪,隨訪率為82.58%,隨訪時間6-39個月,平均隨訪時間19.14±9.33個月。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)后慢性腰痛的危險因素有BMI、術(shù)前慢性腰痛、手術(shù)時間、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)后慢性腰痛獨立危險因素有術(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)計學意義(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)生率比較無統(tǒng)計學意義(p0.05)。結(jié)論:1、對女性患者而言,圍絕經(jīng)期是腰椎退變性疾病術(shù)后慢性腰痛的獨立危險因素。2、對女性患者而言,BMI、術(shù)前慢性腰痛、手術(shù)時間、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.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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