焦虑和抑郁症状对腰椎手术患者生活质量的影响

Effect of Anxiety and Depressive Symptoms on Quality of Life in Patients Undergoing Lumbar Surgery

为了探讨后路腰椎椎间融合术对腰椎退行性疾病患者预后的影响,并揭示手术前后焦虑和抑郁症状对患者生活质量的影响,本研究以76例行后路腰椎椎间融合术的退行性腰椎疾病患者作为研究对象,比较手术前和手术后12个月患者的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和健康调查简表-36(SF-36),并通过医院焦虑和抑郁量表(HADS)评估患者焦虑和抑郁症状。患者手术治疗12个月后,VAS疼痛从9.64±4.21下降到5.51±2.41,ODI从(77.08±33.68)%下降到(51.70±22.59)%。术后SF-36领域内,功能、身体方面的局限性、疼痛、活力、社交和情感方面显著改善(p<0.05)。术后12个月随访时,没有焦虑症状的患者在疼痛、活力、社交方面和心理方面表现出更好的结果,而没有抑郁症的患者在疼痛、总体健康、活力、社交方面、情绪方面和心理健康方面均表现出更好的结果(p<0.05)。研究结论初步说明,后路腰椎椎间融合术可有效改善腰椎退行性疾病患者的疼痛、功能、身体方面的局限性、活力、社交方面和情绪方面。没有焦虑和抑郁症状的患者与具有焦虑和抑郁症状的患者相比,具有更好的健康相关的生活质量。

To investigate the effect of posterior lumbar interbody fusion on the prognosis of patients with lumbar degenerative disease, and to reveal the influence of anxiety and depressive symptoms before and after operation on the quality of life of patients, 76 patients with degenerative lumbar spine disease undergoing posterior lumbar interbody fusion were studied. Visual analogue scale (VAS), Oswestry dysfunction index (ODI), and the MOS item short from health survey (SF-36) were compared between preoperative and postoperative 12 months. The patient's anxiety and depressive symptoms were assessed by using the Hospital Anxiety and Depression Scale (HADS). After 12 months of surgical treatment, VAS pain decreased from 9.64±4.21 to 5.51±2.41, and ODI decreased from (77.08±33.68)% to (51.70±22.59)%. Within the postoperative SF-36 area, functional, physical limitations, pain, vitality, social and emotional improvements were significantly improved (p<0.05). At the 12 month follow-up, patients with no symptoms of anxiety showed better results in terms of pain, vitality, social and psychological aspects, and patients without depression were in pain, general health, vitality, social aspects, mood, and mental health showed better results (p<0.05). In conclusion,posterior lumbar interbody fusion can effectively improve the pain, function, physical limitations, vitality, social aspects and emotional aspects of patients with degenerative lumbar spine;while patients without anxiety and depressive symptoms had better health-related quality of life than those with anxiety and depressive symptoms.