摘要
目的探讨80岁以上退变性腰椎管狭窄症(degenerative lumbar spinal stenosis,DLSS)患者行椎间孔镜手术满意度的术前预测因素。方法选择2017年1月~2019年12月在本院接受椎间孔镜手术的126例高龄DLSS患者作为研究对象,根据术后12个月时的手术满意度将患者分为满意组(S组,87例,占69.05%)和不满意组(NS组,39例,占30.95%),观察两组患者临床资料差异,采用多因素Logistic回归分析观察影响患者满意度的独立风险因素。结果两组患者性别、糖尿病、高血压、ASA分级、饮酒、Ⅰ度腰椎滑脱、手术时间等差异均无统计学意义(P>0.05);NS组年龄、体质量指数和吸烟、腰椎侧凸的占比均显著高于S组(P<0.05)。术后12个月,S组JOA评分、SF-8生理维度评分、SF-8心理维度评分均显著高于NS组,腰痛VAS和腿痛VAS评分均显著低于NS组(P<0.05)。二分类多因素Logistic回归分析显示,吸烟和轻度腰椎侧凸(≤15°)是影响手术满意度的术前预测因素(P<0.05)。结论吸烟和轻度脊柱侧凸与高龄(≥80岁)DLSS患者椎间孔镜术后满意度降低有关。
Objective To explore the preoperative predictors of satisfaction with Intervertebral foramen endoscopic surgery in patients over 80 years old with degenerative lumbar spinal stenosis(DLSS).Methods A total of 126 elderly patients with DLSS who underwent lumbar decompression in our hospital from January 2017 to December 2019 were selected as the research objects.According to the patients’satisfaction with the operation 12 months after operation,the patients were divided into the satisfaction group(S group,87 cases,accounting for 69.05%)and the dissatisfaction group(NS group,39 cases,accounting for 30.95%).The differences in clinical data between the two groups were observed,and the independent risk factors influencing patient satisfaction were observed by multivariate logistic analysis.Results There was no significant difference between the two groups in gender,diabetes,hypertension,ASA grade,alcohol consumption,degree I lumbar spondylolisthesis,and operation time(P>0.05);the proportion of age,body mass index,smoking,and the proportion of lumbar scoliosis in the NS group was significantly higher than that in the S group(P<0.05).Twelve months after surgery,the JOA score,SF-8 physiological dimension score,and SF-8 psychological dimension score in the S group were significantly higher than those in the NS group,while the VAS scores for low back pain and leg pain were significantly lower than those in the NS group(P<0.05).A binary multivariate logistic regression analysis showed that smoking and mild lumbar scoliosis(≤15°)were preoperative predictive factors affecting surgical satisfaction(P<0.05).Conclusion Smoking and mild scoliosis are associated with decreased satisfaction after DLSS in elderly patients(≥80 years old).
作者
喻瑶瑶
郭蕾蕾
罗春梅
YU Yao-yao;GUO Lei-lei;LUO Chun-mei(School of Nursing,Jinzhou Medical University,Jinzhou,Liaoning 121001,China;Medical Aesthetics Department of Chongqing Songshan Hospital,Chongqing 4014120,China;Department of Orthopedics,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)
出处
《颈腰痛杂志》
2024年第1期28-31,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
高龄患者
腰椎管狭窄
经皮内窥镜手术
椎间孔入路
椎管减压术
患者满意度
elderly patients
lumbar spinal stenosis
percutaneous endoscopic surgery
intervertebral foramen approach
spinal canal decompression
patient satisfaction
