腰椎管狭窄症患者行单侧双通道内镜下手术后行走能力的影响因素分析

Analysis of Influencing Factors of Walking Ability in Patients with Lumbar Spinal Stenosis after Unilateral Dual-channel Endoscopic Surgery

目的:探讨腰椎管狭窄症(LSS)患者行单侧双通道内镜下椎管减压术后行走能力的影响因素。方法:回顾性分析2021年4月—2022年2月在江西中医药大学附属医院行单侧双通道内镜下椎管减压手术治疗的80例腰椎管狭窄症患者的临床资料。采用6分钟步行距离(6MWD)评估患者术后(3个月)行走能力,采用多元线性回归模型筛选影响患者术后行走能力的影响因素。结果:性别、身高、居住地、文化程度、高血压、术前视觉模拟评分法(visual analogue scale,VAS)评分、抽烟史、饮酒史、婚姻状况不同的患者术后6MWD对比,差异均无统计学意义(P>0.05)。年龄≥60岁、体重≥130 kg、术前抑郁自评量表(self-rating depression scale,SDS)评分>70分、伴有糖尿病、手术时间≥2 h、住院时间≥10 d、术后功能锻炼未锻炼的6MWD显著短于年龄<60岁、体重<130 kg、术前SDS评分≤70分、无糖尿病、手术时间<2 h、住院时间<10 d、术后功能锻炼行锻炼,差异均有统计学意义(P<0.05)。多元线性回归分析结果显示,年龄、体重、术前SDS评分、糖尿病、手术时间、住院时间、术后功能锻炼均为影响腰椎管狭窄症患者术后6MWD的因素(P<0.05)。结论:年龄≥60岁、体重≥130 kg、术前SDS评分>70分、糖尿病病史、手术时间≥2 h、住院时间≥10 d、术后未进行功能锻炼等均为腰椎管狭窄症患者术后行走能力的影响因素,临床治疗期间医务人员可根据上述因素针对可控因素制订个体化的预防干预措施,进而有助于提高患者术后行走能力,优化患者临床效果。

Objective:To investigate the influencing factors of walking ability in patients with lumbar spinal stenosis(LSS)who underwent unilateral dual-channel endoscopic decompression of the spinal canal.Method:A retrospective analysis was conducted on the clinical data of 80 patients with lumbar spinal stenosis who underwent unilateral dual-channel endoscopic spinal canal decompression surgery in the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from April 2021 to February 2022.The 6-minute walking distance(6MWD)was used to evaluate the walking ability of the patients after surgery(3 months),and the multiple linear regression model was used to screen the influencing factors of the postoperative walking ability of the patients.Result:There were no statistically significant differences in postoperative 6MWD among patients with different gender,height,place of residence,educational level,hypertension,preoperative visual analogue scale(VAS)score,smoking history,drinking history,and marital status(P>0.05).6MWD of patients with age≥60years,weight≥130 kg,preoperative self rating depression scale(SDS)score>70 scores,with diabetes,operation time≥2 h,hospital stay≥10 d,postoperative functional exercise without exercise were significantly shorter than those with age<60 years,weight<130 kg,preoperative SDS score≤70 scores,no diabetes,operation time<2 h,hospital stay<10 d,postoperative functional exercise with exercise,the differences were statistically significant(P<0.05).The results of multiple linear regression analysis showed that age,body weight,preoperative SDS score,diabetes mellitus,operation time,hospital stay and postoperative functional exercise were all influencing factors on postoperative 6MWD in patients with lumbar spinal stenosis(P<0.05).Conclusion:Age≥60 years old,weight≥130 kg,preoperative SDS score>70 scores,history of diabetes,operation time≥2 h,hospitalization time≥10 d,and no functional exercise after operation are all postoperative walking ability of patients with lumbar spinal stenosis.During clinical treatment,medical staff can formulate individualized preventive intervention measures for controllable factors based on the above factors,which will help improve patients'postoperative walking ability and optimize patients'clinical efficacy.