老年退行性腰椎管狭窄症患者围手术期心理状况评估

Evaluation of the perioperative psychological status in senile patients with degenerative lumbar spinal stenosis

目的探讨老年退行性腰椎管狭窄症(DLSS)患者围手术期心理状况,为其心理疾病防治提供参考。方法以2014年1月-2015年6月在绵阳市第三人民医院脊柱外科进行手术治疗的125例老年DLSS患者为研究对象。于术前、术后1周、术后半年和术后1年采用Oswestry功能障碍指数(ODI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表24项版(HAMD-24)进行测评。结果术后86例患者随访1~2年,平均随访1.4年。术前与术后各时间点ODI、HAMA、HAMD-24评分比较差异均有统计学意义(P均<0.05)。其中术前和术后1年ODI评分[(46.00±1.81)分vs.(11.00±1.64)分]、HAMA评分[(24.18±2.20)分vs.(5.15±1.15)分]、HAMD-24评分[(29.46±2.30)分vs.(7.52±2.00)分]比较差异均有统计学意义(P均<0.05),减分率分别为87%、79%和76%。结论老年DLSS患者围手术期可能存在焦虑或抑郁症状。

Objective To investigate the psychological status in senile patients with degenerative lumbar spinal stenosis （DLSS） during the perioperative period, and to provide references for preventing anxiety or depression. Methods A total of 125 senile patients with DLSS were recruited who were treated with spine surgery in the Third People s Hospital of Mianyang from January 2014 to June 2015. The Oswestry Dysfunction Index （ ODI） , Hamilton Anxiety Scale （ HAMA） and Hamilton Depression Scale - 24 item（HAMD -24） were used to evaluated the outcomes before and after the surgery of 1 week, half a year after and one year. Results After operation, 86 patients were followed up for 1 -2 years, with an average follow - up of 1.4 years. There were statistically significant differences of ODI, HAMA and HAMD -24 scores of different time points（P 〈0. 05）. Compared with the datas before surgery, the ODI scores [ （46. 00 ± 1. 81） vs. （ 11.00 ± 1. 64 ） ] , HAMA scores [（24.18±2.20）vs. （5.15±1.15）], the HAMD -24 scores[ （29.46 ±2. 30） vs. （7. 52 ±2. 00） ] after surgery for one year were statistically significant different（P 〈0. 05）. The reduction rates of ODI, HAMA and HAMD - 24 scores during the two periods were 87% , 79% and 76% ,respectively. Conclusion Anxiety and depression may be exist in elderly patients with DLSS during the perioperative period.