老年腰椎间盘突出症患者术后康复依从性的影响因素分析

Influencing Factors of Postoperative Rehabilitation Compliance in Elderly Patients with Lumbar DiscHerniation

目的分析老年腰椎间盘突出症(LDH)患者术后康复依从性的影响因素。方法选取2022年3月至2024年3月于某医院接受椎间孔镜治疗的186例老年LDH患者病历资料,调查其一般资料、临床特征、术后康复依从性,比较不同临床特征患者的康复依从性评分差异,并采用多重线性逐步回归分析其影响因素。结果老年LDH患者康复依从性总分为(32.34±4.41)分,术后3个月恐动症Tampa量表(TSK)评分为(39.43±4.75)分、Connor-Davidson心理韧性量表(CD-RISC)评分为(33.71±5.78)分、社会支持评定量表(SSRS)评分为(23.55±3.64)分。不同文化程度、居住方式、日本骨科学会下腰痛评分量表(JOA)评分、数字疼痛量表(NRS)评分的老年LDH患者康复依从性得分比较,差异有统计学意义(P<0.05)。Pearson相关性分析显示,老年LDH患者康复依从性与TSK评分呈负相关(r=-0.570,P<0.05),老年LDH患者康复依从性与CD-RISC、SSRS评分均呈正相关(r=0.611、r=0.631,P<0.05);多重线性逐步回归分析结果显示,初中及以下文化程度、独居或其他居住方式及JOA、NRS、TSK、CD-RISC、SSRS评分均为老年LDH患者康复依从性的影响因素(P<0.05)。结论老年LDH患者康复依从性整体水平较低,且受到文化程度、居住方式、腰椎功能、术后慢性疼痛、恐动症、心理弹性及社会支持等多因素影响。

Objective To investigate the influencing factors of postoperative rehabilitation compliance in elderly patients with lumbar disc herniation(LDH).Methods The medical records of 186 elderly patients with LDH who received transforaminal endoscopic treatment in a hospital from March 2022 to March 2024 were included.The general data,clinical characteristics and rehabilitation compliance after transforaminal endoscopic treatment were investigated.The differences in rehabilitation exercise compliance scores were compared among patients with different clinical characteristics.Multiple linear stepwise regression analysis was used to analyze the influencing factors of rehabilitation training compliance in elderly patients with LDH after transforaminal endoscopic treatment.Results The total score of rehabilitation training compliance in elderly LDH patients was(32.34±4.41)points.At 3 months after surgery,the Tampa Scale for Kinesiophobia(TSK),Connor-Davidson Resilience Scale(CD-RISC)and Social Support Rating Scale(SSRS)scores were(39.43±4.75)points,(33.71±5.78)points and(23.55±3.64)points,respectively.There were statistically significant differences in rehabilitation training compliance scores among elderly LDH patients with different educational levels,living styles,Japanese Orthopaedic Association(JOA)Back Pain Evaluation Questionnaire scores and Numeric Rating Scale(NRS)scores(P<0.05).Pearson correlation analysis showed that the rehabilitation training compliance score in elderly LDH patients was negatively correlated with TSK score(r=-0.570,P<0.05),but positively correlated with CD-RISC and SSRS scores(r=0.611,r=0.631,P<0.05).Multiple linear stepwise regression analysis showed that education level of junior high school and below,living alone or other living styles,and scores of JOA,NRS,TSK,CD-RISC and SSRS were all influencing factors of rehabilitation training compliance in elderly LDH patients(P<0.05).Conclusion The compliance of rehabilitation training in elderly patients with LDH is generally at a low level,and is affected by many factors such as education level,living style,lumbar function,postoperative chronic pain,kinesiophobia,psychological resilience and social support.