改良腰腿痛PRO量表用于椎间孔镜治疗腰椎管狭窄症的评价价值

Clinical Values of Modified Lumbocrural Pain PRO Scale for Treatment of Lumbar Spinal Stenosis by Intervertebral Foramen Endoscope

目的检验改良后腰腿痛患者报告结局(patient-reported outcomes,PRO)量表的信度、效度及反应度并探讨改良后PRO量表是否可作为椎间孔镜治疗腰椎管狭窄症手术疗效的客观评价工具。方法采用改良腰腿痛PRO表评估椎间孔镜治疗60例腰椎管狭窄症疗效。结果改良PRO量表接受率和完成率均为100%。改良PRO量表在初测和复测的数值差异比较无统计学意义(P>0.05),经直线相关分析发现Cronbach’α系数与Guttman分半信度系数有显著正相关性(r>0.9)。量表总分数和各方面分数的Guttman分半信度系数和Cronbach’α系数值具有正相关性(r>0.8),量表及各个方面的内在信度和效度评价均较好;复测时的总评分和各项平均分均低于初测时,差异比较有统计学意义(P<0.05),改良后的PRO量表的反应度评价较高。结论改良腰腿痛PRO表有较好的信度、效度及反应度,适合用于椎间孔镜治疗腰椎管狭窄症疗效的评价工具。

Objective To detect the reliability, validity and reaction degree of the modified lumbocrural pain patient-re- ported outcomes （PRO） scale, and explore whether it could be objectively used as a tool to evaluate the surgical efficacy of lumbar spinal stenosis using intervertebral foramen endoscope. Methods Sixty patients with lumbar spinal stenosis under intervertebral foramen endoscope were collected. Modified lumboerural pain PRO scale was used to assess the surgical efficacy, reliability, validity and reaction degree. Results The acceptance and completion rates of modified PRO scale were 100%, and there was no significant difference between first and second test （P〉0. 05）. The linear correlation analysis showed Cronbach＇α coefficient value was positive correlate with Guttman split half reliability coefficient （r〈0. 9）. Positive correlation existed between Guttman split half reliability coefficient and Cronbaeh＇α coefficient value of the total scores and scores in all directions （r〈0. 8）. Internal reliability and validity in the scale and its various aspects were better. The total score and every average were lower in second test than first test （P〈0. 05）. The reaction degree evaluation of the modified PRO scale was higher. Clnclusion Modified PRO scale has a good reliability, validity, and reaction degree, meanwhile it is very suitable for evaluating surgical efficacy of lumbar spinal ste- nosis under transformational endoscope.