本文選題：腰椎滑脫 + 焦慮��； 參考：《中國矯形外科雜志》2017年01期

【摘要】：[目的]觀察腰椎滑脫患者行腰椎滑脫切開復(fù)位融合術(shù)后抑郁、焦慮的改善情況,探討腰椎滑脫患者術(shù)前抑郁焦慮對預(yù)后的影響。[方法]回顧性分析2010年1月~2015年1月于本院行腰椎滑脫(I度)切開復(fù)位融合術(shù)的125例患者術(shù)前術(shù)后抑郁、焦慮心理狀況。于術(shù)前及術(shù)后1周、3個月、6個月、1年及末次隨訪時采用Zung抑郁自評量表(SDS)和Zung焦慮自評量表(SAS)評估患者負性心理,腰背疼痛視覺模擬評分(BP-VAS)、腿部疼痛(LP-VAS)及日本骨科學(xué)會(JOA)評分評估神經(jīng)功能,術(shù)后返回工作時間、SF-36量表評估生活質(zhì)量,以單因素相關(guān)分析對結(jié)果進行統(tǒng)計處理。[結(jié)果]所有患者臨床癥狀及神經(jīng)功能都有所改善,18例患者術(shù)前出現(xiàn)明顯的抑郁,37例患者出現(xiàn)焦慮;術(shù)后患者SDS及SAS評分均較術(shù)前改善,焦慮改善程度有統(tǒng)計學(xué)意義,抑郁改善程度無統(tǒng)計學(xué)意義。末次隨訪時患者抑郁及焦慮評分與VAS、術(shù)后返回工作時間和SF-36評分顯著相關(guān),但與JOA評分無顯著相關(guān)。[結(jié)論]部分腰椎滑脫患者術(shù)前存在抑郁和焦慮,腰椎滑脫切開復(fù)位融合術(shù)可以部分改善這種負性心理,患者的負性心理對其預(yù)后有負性作用,術(shù)前抑郁及焦慮程度是一項關(guān)于腰椎滑脫切開復(fù)位融合術(shù)的患者術(shù)后返回工作時間的獨立預(yù)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.
【作者單位】： 南京軍區(qū)福州總醫(yī)院骨科;
【分類號】：R687.3;R749

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