摘要
背景经皮脊柱内镜手术治疗腰椎间盘突出症的日间手术模式逐渐在国内开展,日间手术模式和住院手术模式对于患者心理状态的影响鲜有报道。目的探讨在日间手术与住院手术模式下经皮脊柱内镜手术对于患者心理状态的影响及差异。方法收集2020年1月—2023年1月在解放军总医院第一医学中心骨科接受经皮脊柱内镜腰椎间盘切除术(percutaneous endoscopic lumbar diskectomy,PELD)患者的临床资料,应用倾向评分匹配(propensity score matching,PSM)法对日间手术组和住院手术组患者按照1∶1进行匹配。比较日间手术组和住院手术组术前术后以及两组之间的Zung焦虑自评量表(self-assessment anxiety scale,SAS)评分、Zung抑郁自评量表(self-assessment depression scale,SDS)评分、下肢疼痛视觉模拟评分(visual analog scale of lower limbs,VAS-L)、背部疼痛视觉模拟评分(visual analog scale of back,VAS-B)、日本骨科医师协会评分(Japanese Orthopaedic Association,JOA)和Oswestry功能障碍指数(Oswestry disability index,ODI)。结果匹配后日间手术组和住院手术组各纳入50例患者。日间手术组中,男性31例,女性19例,平均年龄(43.06±15.22)岁,平均病程(20.39±38.41)个月;住院手术组中,男性29例,女性21例,平均年龄(41.40±14.84)岁,平均病程(22.27±40.38)个月,两组一般资料差异无统计学意义(P>0.05)。术前,日间手术组与住院手术组心理学评分及异常率的差异均无统计学意义(P>0.05)。术后,两组各个时间点的SAS评分、SDS评分和异常率均优于术前(P<0.05)。日间手术组与住院手术组相比,出院时的SAS评分差异有统计学意义(34.52±3.43 vs 36.58±4.52,P<0.05),SAS评分异常率差异有统计学意义(16%vs 34%,P=0.038);术后1周的SAS评分差异有统计学意义(28.77±2.52 vs 31.18±3.17,P<0.01);术后其他时间点的SAS评分、SDS评分和异常率差异均无统计学意义(P>0.05)。此外,两组术后3个月的临床疗效�
Background The day surgery mode of percutaneous spinal endoscopic surgery is gradually being carried out in China.Few reports have been published on impacting patients'psychological status between day surgery and inpatient surgery modes.Objective To investigate the effects and differences of day and inpatient surgery modes on patients'psychological status after percutaneous spinal endoscopic surgery.Methods Clinical data about patients who underwent percutaneous endoscopic lumbar diskectomy from January 2020 to January 2023 in the Department of Orthopedics of the First Medical Center of Chinese PLA General Hospital were collected.Propensity score matching(PSM)was used to match patients in the day surgery and inpatient surgery group on a 1:1 basis.The preoperative and postoperative Zung self-assessment anxiety scale(SAS)score,Zung selfassessment depression scale(SDS)score,visual analog scale of lower limbs(VAS-L),visual analog scale of back(VAS-B),Japanese Orthopaedic Association(JOA)score and Oswestry disability index(ODI)were compared between the day surgery group and inpatient surgery group.Results After propensity score matching(PSM),50 patients were included in day surgery group and 50 cases in inpatient surgery group.In the day surgery group,there were 31 males and 19 females,with a mean age of(43.06±15.22)years and a mean disease duration of(20.39±38.41)months,while in the inpatient surgery group,there were 29 males and 21 females,with a mean age of(41.40±14.84)years and a mean disease duration of(22.27±40.38)months.Preoperatively,there was no statistically significant difference between the psychological scores and abnormality rates between the day and inpatient surgery groups(P>0.05).Postoperatively,the SAS scores,SDS scores,and abnormality rates at all time points were better than preoperatively in both groups.The difference in SAS scores at discharge was statistically significant in the day surgery group compared with the inpatient surgery group(34.52±3.43 vs 36.58±4.52,P<0.05),and the difference
作者
李冰
王天昊
黄逸
范一鸣
于涵
郑国权
王岩
LI Bing;WANG Tianhao;HUANG Yi;FAN Yiming;YU Han;ZHENG Guoquan;WANG Yan(Chinese PLA Medical School,Beijing 100853,China;Department of Orthopaedics,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;School of Medicine,Nankai University,Tianjin 300071,China)
出处
《解放军医学院学报》
CAS
2024年第2期136-141,共6页
Academic Journal of Chinese PLA Medical School
