腰椎间盘突出症患者术后并发恐动症的危险因素及护理对策

Risk Factors and Nursing Countermeasures of Postoperative Kinetophobia in Patients with Lumbar Intervertebral Disc Herniation

目的:探讨腰椎间盘突出症(LDH)患者术后并发恐动症的危险因素及护理对策。方法:选取2019年3月—2020年4月阳江市中医医院收治的210例进行手术治疗的LDH患者作为研究对象,根据术后有无发生恐动症,将患者分为发生组(69例)和未发生组(141例)。统计患者相关基线资料,分析LDH患者术后并发恐动症的危险因素。结果:210例进行手术治疗的LDH患者中,69例术后发生恐动症,占32.86%。经单因素分析结果显示,发生组术前放射下肢痛、病程>2年占比高于未发生组,视觉模拟(VAS)评分、医院焦虑抑郁量表(HADS)评分高于未发生组,自我效能感量表(GSES)评分低于未发生组,差异有统计学意义(P<0.05);两组患者其他临床资料比较,差异无统计学意义(P>0.05)。经多因素logistic回归分析结果显示,术前放射下肢痛、病程>2年、VAS评分及HADS评分高、GSES评分低均是LDH患者术后并发恐动症的危险因素(OR>1,P<0.05)。结论:术前放射下肢痛、病程>2年、VAS评分及HADS评分高、GSES评分低是LDH患者术后并发恐动症的危险因素,临床应根据上述影响因素,制定针对性干预措施,以降低术后并发恐动症发生率。

Objective:To investigate the risk factors and nursing countermeasures of postoperative kinetophobia in patients with lumbar disc herniation(LDH).Methods:Two hundred and ten patients with LDH admitted to the hospital for surgical treatment from March 2019 to April 2020 were selected for the study,and the patients were divided into an occurrence group(69 cases)and a non-occurrence group(141 cases)according to the presence or absence of postoperative kinetophobia.Baseline data related to patients were counted and risk factors for postoperative complications of agoraphobia in patients with LDH were analyzed.Results:Of the 210 patients with LDH who underwent surgical treatment,69(32.86%)developed postoperative kinetophobia.The results of univariate analysis showed that the percentage of preoperative radiating lower limb pain and disease duration>2 years was higher in the occurrence group than in the non-occurrence group,and the VAS score and HADS score were higher than in the non-occurrence group,and the GSES score was lower than in the non-occurrence group,with statistically significant differences(P<0.05).There was no statistically significant difference between the other clinical data of the two groups of patients(P>0.05).The results of logistic multifactorial analysis showed that preoperative radiating lower extremity pain,disease duration>2 years,high VAS score and HADS score,and low GSES score were all risk factors for postoperative complications of agoraphobia in patients with LDH(OR>1,P<0.05).Conclusion:Preoperative radiating lower extremity pain,disease duration>2 years,high VAS score and HADS score,and low GSES score are risk factors for postoperative complications of kinetophobia in patients with LDH,and clinics should develop targeted interventions to reduce the incidence of postoperative complications of kinetophobia based on these influencing factors.