颈椎病患者术前焦虑及抑郁状态危险因素分析

Risk factors of preoperative anxiety and depression in patients with cervical spondylosis

为探究颈椎病手术患者术前焦虑和抑郁的患病率及其危险因素,进而确定术前需要加强心理干预的患者,选择从2019年9月至2020年9月在宁波市第六医院脊柱外科收治的因颈椎病需要手术治疗的患者作为研究对象,采用医院焦虑抑郁量表对患者进行抑郁和焦虑评定,统计患者的人口学特征、颈椎退变及计划手术治疗等相关情况,采用Logistic回归分析确定患者术前焦虑和抑郁状态的危险因素.研究结果发现:在所有204名患者中焦虑评分大于8分的占56.9%,抑郁评分大于8分的占51.0%.多因素Logistic回归分析结果显示:年龄、身体质量指数(Body Mass Index, BMI)、神经症状持续时间、术前疼痛视觉模拟评分(Visual Analogue Scale, VAS)、合并其他正在接受治疗的慢性疾病是术前发生焦虑的独立危险因素,而已婚则是焦虑状态的保护因素.表明颈椎病术前患者焦虑抑郁状态常见,医护人员应特别关注年龄较大、BMI指数较大、神经症状持续时间较长、术前VAS评分较高以及合并有其他正在接受治疗的慢性疾病手术患者的心理状况.

The present study was designed to investigate the prevalence and risk factors of anxiety and depression in surgical patients with cervical spondylosis. Patients who underwent surgical treatment with cervical spondylosis were recruited from the Department of Spinal Surgery in Ningbo No.6 Hospital from September, 2019 to September, 2020. All participants were surveyed, using the Hospital Anxiety Depression Scale(HADS). In addition, demographic characteristics, cervical vertebra degeneration and surgical treatment plan were recorded by a same nurse. Logistic regression analysis was used to determine the risk factors of anxiety and depression prior to operation. The results showed that among all 204 participants, 56.9% and 51.0%of the patients were in depression and anxiety, respectively. Logistic regression analysis showed that age, BMI,duration of neurological symptoms, preoperative VAS score, with other ongoing chronic diseases were independent risk factors of preoperative anxiety. In contrast, marital status was a protective factor. In conclusion,anxiety and depression were common in patients with cervical spondylosis prior to surgery. Medical service providers should offer more care to the patients, particularly those elderly, with higher BMI, longer duration of neurological symptoms, higher preoperative VAS score and other ongoing chronic diseases.