摘要
目的探索颈椎间盘疾病患者预后评估的有效指标,以监测患者预后效果、早期预防,进而降低患者远期并发症发生率。方法选取2013年1月—2015年1月就诊于南通大学附属医院脊柱外科的确诊为颈椎间盘疾病患者113例,收集并整理患者入院时的临床资料(性别、年龄、病程、吸烟史、基础疾病、疾病诊断)、术前功能评估[日本骨科协会评估治疗分数(JOA)评分、视觉模拟评分法(VAS)评分、颈椎障碍功能指数(NDI)、颈椎活动度(ROM)]及影像学检查结果,记录术中数据(手术方式、手术节段、手术时间、术中出血量)。对患者进行为期2年的随访,统计终点事件发生情况,采用多因素Cox回归分析分析颈椎间盘疾病患者预后的影响因素;绘制受试者工作特征(ROC)曲线,采用ROC曲线下面积(AUC)评价潜在指标对颈椎间盘疾病患者预后的预测能力。结果多因素Cox回归分析结果显示:病程、JOA评分、VAS评分、NDI是影响颈椎间盘疾病患者预后的影响因素(P<0.05)。JOA评分、VAS评分、NDI预测颈椎间盘疾病预后的AUC均大于病程(P<0.05)。结论 JOA评分、VAS评分、NDI联合可组成一个颈椎间盘疾病患者预后预测评估系统,有望在临床上指导颈椎间盘疾病患者的治疗方案。
Objective To explore the factors for predicting the prognosis of cervical intervertebral disc disease(CIDD),providing evidence for early delivering preventive care for reducing the incidence of long-term complications.Methods One hundred and thirteen patients who received a confirmed diagnosis of CIDD and treatment from Department of Spinal Surgery,Affiliated Hospital of Nantong University were involved from January 2013 to January 2015.Baseline clinical data(sex,age,duration of suffering from CIDD,duration of smoking,underlying disorders,diagnosis),baseline cervical spine function assessment results〔Japanese Orthopedic Association(JOA)score,visual analogue scale(VAS)score,Neck Disability Index(NDI),cervical range of motion(ROM)〕and imaging findings were collected and analyzed.Intraoperative data(operative approach,operative segment,operative duration,and intraoperative blood loss)were recorded.All of them were followed up for a period of 2 years and those with end-point events were analyzed.The potential prognostic factors for CIDD were investigated by multivariate Cox regression analysis and their performances were explored by ROC analysis.Results Multivariate Cox regression analysis showed that the duration of suffering from CIDD,JOA score,VAS score,and NDI were independent factors affecting the prognosis(P<0.05).Moreover,the duration of suffering from CIDD demonstrated a much smaller AUC compared with other three prognostic factors(P<0.05).Conclusion JOA score,VAS score,combined with NDI can be used as a predictive evaluation system for CIDD,which is expected to be a guidance for clinical treatment of this disease.
作者
张锦荣
王海燕
冒海敏
魏燕
陈晓庆
张翠红
ZHANG Jinrong;WANG Haiyan;MAO Haimin;WEI Yan;CHEN Xiaoqing;ZHANG Cuihong(Department of Spine Surgery,Affiliated Hospital of Nantong University,Nantong 226001,China)
出处
《中国全科医学》
CAS
北大核心
2018年第33期4088-4093,共6页
Chinese General Practice
基金
南通市应用研究计划项目(BK2011032)
关键词
椎间盘
预后
预测
Intervertebral disc
Prognosis
Forecasting
