腰椎融合术患者术前疗效期望对实际疗效的影响

Analysis of the relationship between hope and curative effect of spinal fusion in patients with chronic low back pain

目的研究腰椎融合术患者术前症状、对手术疗效的希望及手术疗效间的关系。方法中山大学孙逸仙纪念医院骨科,接受腰椎融合术的202例退变性疾病患者,记录术前症状持续时间和疼痛程度,术后下腰部疼痛程度并量化患者对疗效的希望,采用多重线性相关、Pearson相关和卡方检验法分析三者之间的关系。结果术前疼痛程度和疼痛持续时间与疗效希望负相关,相关系数分别为-0.20(P=0.04)与-0.36(P<0.001)。患者对疗效的希望与术后1年的症状缓解程度呈正相关,相关系数为0.28(P=0.04)。症状缓解较差的患者服用药物较多消炎止痛药(P=0.009)。结论长期剧烈的腰痛降低了患者对手术疗效的希望,较低希望值进而削弱手术疗效,因此术前对下腰患者进行心理干预很有必要。

Objective To discuss how the extent of chronic low back pain act on the hope of recovery after spinal fusion,and what is the relationship between hope and the practical curative effect.Methods By retrospective cohort study,the researchers collected VAS score of each patients from before to after operation,and use the means of multilinear correlation analysis,Pearson correlation analysis and chi-square test,to analyze the relationships among those three factors.Results The period and extent of pain correlated with the hope for recovery negatively by the correlation coefficient of-0.02 and-0.36 respectively.The hope of recovery correlated with the one-year actual post-operational state positively with correlation coefficient 0.28.Patients with poor recovery took more pills to labor pains.Conclusion Patients with severe pain or long period of pain intended to lose their good hope for recovery.Low level of good hope reduce the therapeutic effect.Thus appropriated mental intervention is needed.