基线抑郁焦虑状态对青少年特发性脊柱侧凸患者术后生活质量的影响

Effect of baseline depression and anxiety on postoperative quality of life in adolescent idiopathic scoliosis patients

目的:评估术前合并抑郁和焦虑对青少年特发性脊柱侧凸(AIS)患者术后生活质量的影响。方法:选取2023年4—8月北京协和医院收治的130例AIS患者作为研究对象,入院当日使用医院焦虑抑郁量表(HADS)评估患者的抑郁和焦虑状态。根据患者是否合并抑郁分为HADS-D+组(29例)和HADS-D-组(101例),根据患者是否合并焦虑分为HADS-A+组(37例)和HADS-A-组(93例)。在术前和术后6个月,采用脊柱侧凸研究学会22项量表(SRS-22)对患者进行生活质量评分。结果:术后6个月,HADS-D+组患者SRS-22总分及治疗满意度评分均低于HADS-D-组患者,差异均有统计学意义(P均<0.05);无论是否合并抑郁,患者SRS-22总分及自我形象、患者满意度评分均高于术前,差异均有统计学意义(P均<0.05);HADS-D-组患者疼痛、心理状况评分均高于术前,差异均有统计学意义(P均<0.05)。术后6个月,HADS-A+组患者活动能力、心理状况、治疗满意度评分均低于HADS-A-组患者,差异均有统计学意义(P均<0.05);无论是否合并焦虑,患者SRS-22总分及自我形象、治疗满意度评分均高于术前,差异均有统计学意义(P均<0.05);HADS-A-组患者疼痛、心理状况评分均高于术前,差异均有统计学意义(P均<0.05)。不论是否合并抑郁或焦虑的患者,脊柱侧凸严重程度比较差异均无统计学意义(P均>0.05)。结论:AIS患者接受脊柱矫形手术后,其生活质量得到显著改善。与不合并抑郁或焦虑的AIS患者相比,合并抑郁或焦虑的AIS患者术后生活质量较差。

Objective:To evaluate the effect of preoperative depression and anxiety on postoperative quality of life in patients with adolescent idiopathic scoliosis(AIS).Methods:A total of 130 AIS patients admitted to Peking Union Medical College Hospital from April to August 2023 were selected as the study subjects,and the depression and anxiety status of the patients were assessed on the day of admission.HADS-D+group(29-cases)and HADS-D-group(101 cases),and HADS-A+group(37 cases)and HADS-A-group(93 cases).Before and at 6 months after surgery,the quality of life scores were recorded using the Scoliosis Research Society 22-item scale(SRS-22).Results:At 6 months after surgery,the total SRS-22 scores and treatment satisfaction scores in HADS-D+group lower than those in the HADS-D-group,the differences were statistically significant(all P<0.05),the patients with depression or not with SRS-22 had higher total score than before surgery,the differences were statistically ignificant(all P<0.05),and HADS-D-group patients had higher pain and psychological status scores than preoperative,the differences were statistically ignificant(all P<0.05).At 6 months after surgery,the mobility,psychological status and treatment satisfaction scores in HADS-A+group were lower than those in HADS-A-group,the differences were statistically significant(all P<0.05),the SRS-22 total score,self-image and treatment satisfaction scores were higher than those in patients with anxiety,the differences were statistically significant(all P<0.05),and HADS-A-group patients had higher pain and psychological condition scores than preoperative,the differences were statistically significant(all P<0.05).There were no significant differences in the severity of scoliosis in patients with depression or anxiety(all P>0.05).Conclusions:Patients with AIS had significantly improved quality of life after undergoing spinal orthopedic surgery.Comparing to those without depression or anxiety,AIS patients who with depression or anxiety had poor postoperative quality of life.