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不同全髋关节置换术手术入路对患者术后早期焦虑和抑郁的影响。

The influence of different THA surgical approaches on Patient's early postoperative anxiety and depression.

机构信息

State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, PR China.

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.

出版信息

BMC Musculoskelet Disord. 2021 Oct 8;22(1):858. doi: 10.1186/s12891-021-04746-z.

Abstract

INTRODUCTION

Total hip arthroplasty (THA) is generally considered to be one of the most successful orthopedic surgical procedures. However, no research has been conducted on the postoperative mental health of patients who underwent different approaches of THA. This paper seeks to compare the differences among three THA approaches: the normal lateral approach (NLA), the direct anterior approach (DAA) and the orthopädische chirurgie münchen (OCM) regarding their influence on patients' postoperative anxiety and depression.

METHOD

A total of 95 THA patients were recruited for this study. All patients' preoperative information including results of Harris, SF-36 and Visual Analogue Scale (VAS) was carefully evaluated. Surgery-related data as well as five-day postoperative data were also collected. Three months after the surgery, a telephone follow-up was conducted to further evaluate patients' HADS and SF-36 results.

RESULT

In the three-month postoperative evaluation of anxiety and depression, the NLA group scored significantly higher than both the DAA group and the OCM group, which was found relevant to the patient's incision length and five-day postoperative VAS results. A correlation between anxiety scores and the days of postoperative hospitalization was also noticed. Further analysis of patients' psychological state based on the SF-36 results revealed considerable differences in viability (VT) and social function (SF) between the NLA group and the OCM group. Other surgery-related data and postoperative data all demonstrated better results of the DAA group and the OCM group compared to the NLA group.

CONCLUSION

Among the three different surgical approaches of THA, DAA and OCM compared with NLA are found to ease patients' postoperative anxiety and depression.

LEVEL OF EVIDENCE

III.

摘要

简介

全髋关节置换术(THA)通常被认为是最成功的骨科手术之一。然而,目前还没有研究针对接受不同入路 THA 的患者的术后心理健康。本文旨在比较三种 THA 入路(正常外侧入路[NLA]、直接前入路[DAA]和奥古斯塔骨科手术[OCM])对患者术后焦虑和抑郁的影响。

方法

本研究共纳入 95 例 THA 患者。详细评估了所有患者的术前信息,包括 Harris 评分、SF-36 和视觉模拟量表(VAS)的结果。还收集了手术相关数据和术后 5 天的数据。术后 3 个月进行电话随访,进一步评估患者的 HADS 和 SF-36 结果。

结果

在术后 3 个月对焦虑和抑郁的评估中,NLA 组的评分明显高于 DAA 组和 OCM 组,这与患者的切口长度和术后 5 天的 VAS 结果有关。还注意到焦虑评分与术后住院天数之间存在相关性。根据 SF-36 结果进一步分析患者的心理状态,发现 NLA 组和 OCM 组在活力(VT)和社会功能(SF)方面存在显著差异。其他手术相关数据和术后数据均表明,DAA 组和 OCM 组的结果优于 NLA 组。

结论

在三种不同的 THA 手术入路中,与 NLA 相比,DAA 和 OCM 可减轻患者术后的焦虑和抑郁。

证据水平

III 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd9/8501680/45726257dcc0/12891_2021_4746_Fig1_HTML.jpg

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