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焦虑和抑郁症状对腰椎手术患者生活质量的影响。

Influence of anxiety and depression symptoms on the quality of life in patients undergoing lumbar spine surgery.

作者信息

Netto Martins Back, Barranco Ana Beatriz Sanches, Oliveira Karen Waleska Kniphoff de, Petronilho Fabrícia

机构信息

Programa de Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil.

Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil.

出版信息

Rev Bras Ortop. 2017 Dec 1;53(1):38-44. doi: 10.1016/j.rboe.2017.01.009. eCollection 2018 Jan-Feb.

Abstract

OBJECTIVE

Comparative analysis of the quality of life and functionality of patients undergoing lumbar spine arthrodesis due to degenerative lumbar spine disease. The authors sought to correlate the influence of anxious and depressive symptoms before and after surgery.

METHODS

A prospective cohort study was performed, with 32 patients submitted to arthrodesis due to degenerative lumbar spine disease and the visual analogue pain scale pain questionnaire, the Oswestry Disability Index questionnaire, the Medical Outcomes Survey Short Form questionnaire - 36 items (SF-36), and the Hospital Anxiety and Depression Scale, applied in the preoperative period and four months after the procedure.

RESULTS

There was improvement in the mean scores of the visual analogue pain scale ( < 0.001) and the Oswestry Disability Index ( < 0.001). In the preoperative period, the variables that presented a difference between patients with and without anxiety symptoms were the SF-36 domains of general health ( = 0.031), social aspects ( = 0.008), and mental health ( = 0.035). In the postoperative period, patients without anxiety symptoms showed better results in the vitality ( = 0.004), social aspects ( = 0.001), mental health ( < 0.001), and pain ( = 0.011) domains. In the preoperative period, the variable that presented a difference between patients with and without depression was the SF-36 domain of emotional aspects ( = 0.022). In the post-operative period, patients without depression presented better vitality ( < 0.001), social aspects ( < 0.001), emotional aspects ( = 0.004), and mental health results ( = 0.001).

CONCLUSION

Lumbar spine arthrodesis was effective in improving pain, low back pain, functional capacity, limitation due to physical aspects, vitality, and social and emotional aspects. Patients without anxiety and depression symptoms had better results on the scales compared to those with such symptoms.

摘要

目的

对因退行性腰椎疾病接受腰椎融合术患者的生活质量和功能进行比较分析。作者试图关联手术前后焦虑和抑郁症状的影响。

方法

进行了一项前瞻性队列研究,32例因退行性腰椎疾病接受融合术的患者在术前及术后四个月应用视觉模拟疼痛量表疼痛问卷、Oswestry功能障碍指数问卷、医学结局研究简表问卷 - 36项(SF - 36)以及医院焦虑抑郁量表。

结果

视觉模拟疼痛量表(<0.001)和Oswestry功能障碍指数(<0.001)的平均得分有所改善。术前,有无焦虑症状患者之间存在差异的变量是SF - 36的总体健康领域(=0.031)、社会方面(=0.008)和心理健康领域(=0.035)。术后,无焦虑症状的患者在活力领域(=0.004)、社会方面(=0.001)、心理健康领域(<0.001)和疼痛领域(=0.011)表现出更好的结果。术前,有无抑郁患者之间存在差异的变量是SF - 36的情感方面领域(=0.022)。术后,无抑郁的患者在活力领域(<0.001)、社会方面(<0.001)、情感方面(=0.004)和心理健康结果(=0.001)方面表现更好。

结论

腰椎融合术在改善疼痛、腰痛、功能能力、身体方面的限制、活力以及社会和情感方面有效。与有焦虑和抑郁症状的患者相比,无此类症状的患者在量表上的结果更好。

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