关节置换术后恐动症的相关因素分析

An analysis on related factors of kinesiophobia secondary to major joint arthroplasty

[目的]探讨关节置换术后患者恐动症的影响因素。[方法] 2018年1月—2020年12月,在泉州某三级甲等综合性医院接受关节置换术的220例患者纳入本研究,根据恐动症Tampa量表(Tapa scale for phobia, TSK)评分,≥38分判定为恐动症,<38分的为非恐动症。对患者术后发生恐动症的原因进行单因素和多因素分析。[结果] 220例患者中有74例术后发生恐动症,发生率为33.64%,单因素分析显示,与非恐动组相比,恐动症组失眠比率高、文化程度低、月收入低、职业状态差、术后3 d VAS评分高、术后下地时间晩、慢性疼痛自我效能感量表(chronic pain self-efficacy scale, CPSS)评分低,差异均有统计学意义(P<0.05)。逻辑回归分析显示,失眠、文化程度低、月收入低、职业状态差、术后3 d VAS分高、术后下地时间晚、CPSS评分低是术后发生恐动症的危险因素(P<0.05)。[结论]关节置换术后患者恐动症的发生率较高,与失眠、文化程度、月收入、工作状态、术后3 d VAS评分、术后下地时间、CPSS评分相关。

[Objective] To explore the risk factors of kinesiophobia secondary to major joint arthroplasty. [Methods] From January 2018 to December 2020, 220 patients who underwent joint replacement in a general hospital in Quanzhou were enrolled into this study. According to the Tampa scale for kinesiophobia(TSK) score, the patients who were of ≥ 38 were judged as kinesiophobia, while those who were of <38 were considered as non-kinesiophobia. Univariate and multivariate analyses were conducted to search the factors related the kinesiophobia. [Results] Of the 220 patients, 74 patients were diagnosed of kinesiophobia after surgery, accounted for 33.64%. In term of univariate comparison, the kinesiophobia group had significantly higher ratio of insomnia rate, lower education level, lower monthly income,poor occupational status, higher VAS score at 3 days after operation, delayed ambulation after surgery, and lower chronic pain self-efficacy scale(CPSS) score than the non-kinesiophobia group(P<0.05). As results of multivariate logistic regression, the insomnia, low education level, low monthly income, poor occupational status, high VAS score 3 days postoperatively, late ambulation after surgery, and low CPSS score were risk factors for postoperative kinesiophobia(P<0.05). [Conclusion] The incidence of kinesiophobia is relatively high in patients after major joint replacement, which is closely related to insomnia, education level, monthly income, work status, VAS score 3 days after surgery, time to return walking postoperatively and CPSS score.