老年腰椎间盘突出合并椎管狭窄患者术前心理状况及影响因素

Investigation of preoperative mental state and influencing factors in elderly patients with lumbar disc herniation and spinal stenosis

目的 探讨老年腰椎间盘突出合并椎管狭窄患者术前心理状况及其影响因素.方法 于术前对100例拟行手术治疗的老年腰椎间盘突出合并椎管狭窄患者采用焦虑自评量表、抑郁自评量表进行测评分析.结果 患者术前焦虑自评量表、抑郁自评量表评分均显著高于常模(P<0.01),焦虑症状检出率为18.1%,抑郁症状检出率为12.8%.不同年龄、病程、家庭月收入、婚姻状况术前焦虑抑郁检出率比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示,患者病程≥5 a、家庭月收入<3000元、未婚、丧偶或离异是术前焦虑抑郁的独立危险因素(P<0.05).结论 老年腰椎间盘突出合并椎管狭窄患者术前存在不同程度的焦虑抑郁,影响因素主要有病程长(>5 a)、家庭月收入及单身状态,应对其予以针对性干预,以改善预后.

Objective To investigate the preoperative mental state and influencing factors in elderly pa-tients with lumbar disc herniation and spinal stenosis.Methods Before surgery,100 elderly patients with lumbar disc herniation and spinal stenosis who were planned to undergo surgery were evaluated and ana-lyzed by SAS and SDS.Results The preoperative SAS and SDS scores of the enrolled patients were signif-icantly higher than the norm(P<0.01).The detection rate of anxiety symptoms in the enrolled patients was 18.1%,and the detection rate of depression symptoms was 12.8%.The preoperative anxiety and de-pression detection rate of patients with different age,disease course,family monthly income,and marital status was significantly different(P<0.05).Multivariate Logistic regression analysis showed that,pa-tients'age≥5 years,family economic income<3000 yuan/month,unmarried,widowed or divorced were independent risk factors for preoperative anxiety and depression(P<0.05).Conclusions Elderly patients with lumbar disc herniation and spinal stenosis have varying degrees of anxiety and depression before sur-gery.The main influencing factors are long course of disease(>5 years),family monthly income and sin-gle status.Targeted intervention should be given to improve the prognosis.