摘要
目的分析腰椎管狭窄症(lumbar spinal stenosis,LSS)患者减压术后1年功能恢复的影响因素。方法回顾性分析2015年12月至2017年12月本院收治的120例行减压术治疗的LSS患者的临床资料,采用日本矫形外科协会(Japanese Orthopedic Association,JOA)评分系统评估患者术后1年功能恢复情况,将功能恢复良和好的患者纳入恢复良好组,功能恢复中和差的患者纳入恢复不良组。采用单因素和多因素Logistic回归分析探讨影响LSS患者减压术后1年功能恢复的相关危险因素。结果 LSS患者减压术后1年功能恢复良好率为81.67%(98/120)。恢复不良组中年龄≥60岁、合并骨质疏松症、有腰椎合并症、术前抑郁自评量表(self-rating depression scale,SDS)评分>70分、未接受内固定、术后未接受规范化康复指导患者构成比均显著高于恢复良好组(均P<0.05)。多因素Logistic回归分析显示:年龄≥60岁、合并骨质疏松症、有腰椎合并症、术前SDS评分>70分、未接受内固定、术后未接受规范化康复指导均是导致LSS患者减压术后1年功能恢复不良的独立危险因素(OR=3.438、2.570、4.433、3.677、2.056、2.472,均P<0.05)。结论导致LSS患者减压术后功能恢复不良的危险因素较多,临床应给予充分重视并积极采取针对性措施,以进一步改善患者术后功能恢复情况。
Objective To analyze the the influencing factors of functional recovery in patients with lumbar spinal stenosis (LSS) one year after decompression.Method The clinical data of 120 patients with LSS treated with decompression in our hospital from December 2015 to December 2017 were analyzed retrospectively,the functional recovery of the patients was evaluated by the Japanese Orthopedic Association (JOA) scoring system one year after operation,and the patients with excellent and good function recovery were included in well recovery group,while patients with moderate and poor functional recovery were included in poor recovery group.Univariate and multivariate Logistic regression analysis were used to identify the risk factors affecting functional recovery of LSS patients one year after decompression.Result The good rate of functional recovery in one year after decompression in patients with LSS was 81.67%(98/120).The constituent ratios of patients with age ≥ 60 years old,complicated with osteoporosis,lumbar complications,preoperative self-rating depression scale (SDS) score > 70,not receiving internal fixation and postoperative standardized rehabilitation guidance in poor recovery group were significantly higher than those in well recovery group (all P < 0.05).Multivariate Logistic regression analysis showed that age ≥ 60 years old,complicated with osteoporosis,lumbar complications,preoperative SDS score > 70,not receiving internal fixation and postoperative standardized rehabilitation guidance were independent risk factors for poor functional recovery in patients with LSS one year after decompression (OR = 3.438,2.570,4.433,3.677,2.056,2.472,all P < 0.05). Conclusion There are many risk factors leading to poor functional recovery in patients with LSS after decompression,clinical attention should be paid to it and targeted measures should be taken to further improve the functional recovery of patients after decompression.
作者
谭东
高大柱
方策
段文
TAN Dong;GAO Da-zhu;FANG Ce;DUAN Wen(Department of Orthopaedics,the First Affiliated Hospital of USTC,Anhui Province Hospital,Hefei 230031,China)
出处
《中国医学前沿杂志（电子版）》
2019年第6期107-112,共6页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
