本文選題：MED + 腰椎間盤突出癥��； 參考：《石河子大學(xué)》2015年碩士論文

【摘要】：目的:本次研究通過對(duì)腰椎間盤突出癥患者行MED手術(shù)治療后與健康相關(guān)的生活質(zhì)量調(diào)查來了解患者疾病預(yù)后狀態(tài),客觀的評(píng)價(jià)腰椎間盤突出癥術(shù)后的療效,進(jìn)一步分析生活質(zhì)量的影響因素,以期為脊柱微創(chuàng)手術(shù)治療提供參考。方法:選自2011年09月-2013年09月石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院骨一科診斷為“腰椎間盤突出癥”的住院患者,入選患者為行MED治療的患者,共76例。記錄患者一般信息及疾病相關(guān)資料。應(yīng)用SF-36中文版生活質(zhì)量評(píng)價(jià),隨訪觀察并給予評(píng)分。統(tǒng)計(jì)方法采用t檢驗(yàn),Kruscal-Walis秩和檢驗(yàn)、方差分析、相關(guān)分析和多元回歸分析等。使用SPSS17.0處理數(shù)據(jù)。結(jié)果:1.腰椎間盤突出癥患者生活質(zhì)量SF-36各維度評(píng)分均明顯低于一般人群常模,術(shù)后在各維度的評(píng)分均提升。2.對(duì)MED術(shù)后患者生活質(zhì)量獨(dú)立影響因素組間比較發(fā)現(xiàn),年齡方面除去在精神健康維度中老年組平均得分高于青年組,但統(tǒng)計(jì)學(xué)無差異(P0.05),其他維度平均值青年組大于中老年組,在生理機(jī)能,生理職能,軀體疼痛,總體健康以及活力方面統(tǒng)計(jì)學(xué)存在差異;男性患者在大部分維度上得分大于女性患者,在活力維度上差異有意義(P0.05);腦力勞動(dòng)組患者在生理機(jī)能、主觀總體健康、精神健康以及社會(huì)職能維度上與退休人群比較存在差異;初中以下文化程度患者與大學(xué)組患者在生理機(jī)能、軀體疼痛、社會(huì)職能精神健康方面相比,得分明顯低,初中組與高中組相比在軀體疼痛方面存在差異,高中組與大學(xué)組相比,無明顯差異;病程在6月以內(nèi)患者術(shù)后生活質(zhì)量在各維度上均與大于6月病程患者的得分在生理機(jī)能、軀體疼痛方面相比,統(tǒng)計(jì)學(xué)存在差異。病程6月至1年組與大于1年病程組比較得分在各維度上無明顯差異;吸煙對(duì)患者生活質(zhì)量的影響表現(xiàn)各維度不吸煙組得分均高于吸煙組,尤其在軀體疼痛和生理職能維度上差異明顯,有統(tǒng)計(jì)學(xué)意義;腰背肌功能患者在生理機(jī)能,生理職能,軀體疼痛,總體健康維度上明顯高于未堅(jiān)持做腰背肌功能訓(xùn)練患者統(tǒng)計(jì)學(xué)差異明顯。突出類型及節(jié)段對(duì)患者預(yù)后生活質(zhì)量影響比較無統(tǒng)計(jì)學(xué)意義。3.MED術(shù)后生活質(zhì)量與相關(guān)因素多元回歸分析得出,年齡、腰背肌功能鍛煉、吸煙在患者生理評(píng)價(jià)中起主要影響因素,職業(yè)及文化程度在主觀指標(biāo)維度上起主要影響因素。結(jié)論:1.腰椎間盤突出癥患者生活質(zhì)量各維度得分均明顯低于一般常模。MED術(shù)后1年隨訪各維度得分均提高,尤其在生理機(jī)能,生理職能,軀體疼痛,社會(huì)職能方面改善明顯。2.初步探討了人口學(xué)因素、疾病相關(guān)因素與生活質(zhì)量的相關(guān)性,年齡、職業(yè)、吸煙、病程、腰背肌功能鍛煉是影響患者生活質(zhì)量的因素。3.年齡、吸煙、腰背肌功能鍛煉時(shí)影響患者生理健康的主要因素,文化程度是影響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.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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本文編號(hào)：1754257