Yi D, Zhu W, Meng X L, Liu X G, Li S Q, Zhu B, Jia D L
Pain Medicine Department, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Apr 18;52(2):285-289. doi: 10.19723/j.issn.1671-167X.2020.02.015.
To investigate anxiety and/or depression status of patients with chronic lumbocrural pain, and to further analyze related risk factors of anxiety and/or depression .
Retrospective analysis of the medical data of patients who suffered from chronic lumbocrural pain caused by lumbar disc herniation and/or lumbar spinal stenosis and received minimally invasive surgery from March 2018 to April 2018. General data (including age, gender, education levels, past history, sleep order and medical insurance), numeric rating scale(NRS), Japanese Orthopedic Association(JOA) back pain scale and hospital anxiety and depression scale(HADS) were collected for analysis. The basic demographic data and clinic data were analyzed, possible related risk factors associated were analyzed by univariate analysis, and multivariate Logistic regression analysis was further used to find the relative independent risk factors and included all the predictive variables with P values less than 0.05 as covariates.
A total of 91 patients met the inclusion criteria and finished this study, the mean HADS score for anxiety was 8.1±4.2, 48(52.7%) respondents were screened positive for anxiety, while the rest 43(47.3%) patients had negative anxiety state, the mean HDDS score for depression was 6.9±4.9, 38(41.8%) respondents were screened positive for depression, and the rest 53(58.2%) patients were not depressed, and 56(61.5%) patients experienced anxiety or depression. There were significant difference in sleep disorder, JOA score and leg NRS score between the patients with and without anxiety(P<0.05), and the significant differences were also found in age, sleep disorder and JOA score between the patients with and without depression(P<0.05), Logistic regression analysis further showed that the JOA score and sleep disorder were risk factors for anxiety, and the JOA score was risk factor for depression.
Patients with chronic lumbocrural pain are often accompanied by anxiety and/or depression before minimally surgery, the low JOA score and sleep disturbance increased the risk of presenting anxiety, and the low JOA score increased the risk of developing depression. It is necessary to evaluate mental status and related risk factors before surgery.
调查慢性腰腿痛患者的焦虑和/或抑郁状况，并进一步分析焦虑和/或抑郁的相关危险因素。
回顾性分析2018年3月至2018年4月因腰椎间盘突出症和/或腰椎管狭窄症导致慢性腰腿痛并接受微创手术的患者的医疗数据。收集一般资料（包括年龄、性别、教育程度、既往史、睡眠状况和医疗保险）、数字评分量表（NRS）、日本骨科协会（JOA）背痛量表和医院焦虑抑郁量表（HADS）进行分析。对基本人口统计学数据和临床数据进行分析，通过单因素分析分析可能的相关危险因素，进一步采用多因素Logistic回归分析找出相对独立的危险因素，并将所有P值小于0.05的预测变量作为协变量纳入。
共有91例患者符合纳入标准并完成本研究，焦虑的平均HADS评分为8.1±4.2，48例（52.7%）受访者焦虑筛查呈阳性，其余43例（47.3%）患者焦虑状态为阴性，抑郁的平均HDDS评分为6.9±4.9，38例（41.8%）受访者抑郁筛查呈阳性，其余53例（58.2%）患者未抑郁，56例（61.5%）患者有焦虑或抑郁。有焦虑和无焦虑患者在睡眠障碍、JOA评分和腿部NRS评分方面存在显著差异（P<0.05），有抑郁和无抑郁患者在年龄、睡眠障碍和JOA评分方面也存在显著差异（P<0.05），Logistic回归分析进一步表明JOA评分和睡眠障碍是焦虑的危险因素，JOA评分是抑郁的危险因素。
慢性腰腿痛患者在微创手术前常伴有焦虑和/或抑郁，JOA评分低和睡眠障碍增加了出现焦虑的风险，JOA评分低增加了发生抑郁的风险。术前评估心理状态和相关危险因素很有必要。
