老年腰椎间盘突出症患者术后症状群现状、影响因素及与出院准备的相关性分析

Analysis of the status quo of postoperative symptom groups,influencing factors and correlation between postoperative symp-tom groups and discharge readiness in elderly patients with lumbar disc herniation

中文关键词: 老年  腰椎间盘突出症  症状群  影响因素  出院准备度

英文关键词: elderly  lumbar disc herniation  symptom group  influencing factor  discharge readiness

中文摘要:

      目的 分析老年腰椎间盘突出症(LDH)患者术后症状群现状、影响因素及与出院准备的相关性.方法 采用便利抽样法选取2022年11月-2023年11月于上海市第六人民医院收治的188例LDH患者为研究对象,分析他们的术后症状整体情况、症状表现分布,以及症状群严重程度的影响因素,采用Pearson相关性分析术后症状群与出院准备度的相关性.结果 188例LDH患者同时出现症状有2～13个,症状发生率为17.02％～94.14％,其中发生率较高的症状为疼痛、睡眠不安、麻木、昏昏欲睡和苦恼,发生率分别为94.15％、89.89％、86.17％、82.98％和80.85％;症状严重程度评分较高的分别为疼痛、麻木、睡眠不安、胃口差和疲劳乏力,评分分别为(7.21±1.02)、(5.81±1.69)、(5.66±1.48)、(4.99±1.76)和(4.84±1.72)分;LDH患者症状群条目均分严重程度为(4.40±2.13)分,4个症状群条目平均分由高到低依次为神经症状群(6.55±1.55)分、疲乏症状群(5.04±1.55)分、情志症状群(4.43±1.44)分和胃肠道症状群(1.89±0.95)分;单因素分析显示,年龄、病程、焦虑状态、抑郁状态及RHDS评分症状群严重程度得分差异具有统计学意义(P＜0.05),多元逐步回归分析显示,年龄、病程、焦虑状态、抑郁状态及RHDS评分是影响症状群严重程度的独立影响因素(P＜0.05);术后症状群各评分与RHDS评分呈负相关(P＜0.05).结论 老年腰椎间盘突出症患者术后症状发生率较高的是疼痛、睡眠不安、麻木、昏昏欲睡和苦恼,症状群主要包括神经症状群、疲乏症状群、情志症状群和胃肠道症状群,年龄、病程、焦虑状态、抑郁状态和、RHDS评分可能是症状群严重程度的独立影响因素,需尽早发现相关症状,制定相应预防措施,改善患者预后.

英文摘要:

      Objective To analyze the status quo of postoperative symptom groups,influencing factors and the correla-tion between postoperative symptom groups and discharge readiness in elderly patients with lumbar disc herniation(LDH).Methods 188 patients with LDH admitted to Sixth People's Hospital of Shanghai City from November 2022 to November 2023 were selected as the research subjects by convenient sampling method.Their overall situation of postoperative symptoms,the distribution of symptom manifestations and the influencing factors of symptom group severity were analyzed.Pearson correla-tion was used to analyze the correlation between postoperative symptom group and discharge readiness.Results Among 188 LDH patients,there were 2-13 concurrent symptoms,and the incidence ranged from 17.02％to 94.14％.The symptoms with a high incidence rate were pain,restless sleep,numbness,drowsiness and distress,with incidence of 94.15％,89.89％,86.17％,82.98％and 80.85％,respectively.The highest symptom severity scores were pain,numbness,restless sleep,poor appetite and fatigue,and their scores were(7.21±1.02),(5.81±1.69),(5.66±1.48),(4.99±1.76)and(4.84±1.72),respectively.The average score of the severity of symptom group items was(4.40±2.13)points.The average scores of the four symptom group items,from high to low,were as follows:neurological symptom group(6.55±1.55)points,fa-tigue symptom group(5.04±1.55)points,emotional symptom group(4.43±1.44)points and gastrointestinal symptom group(1.89±0.95)points.Univariate analysis showed that there were statistically significant differences in age,course of dis-ease,anxiety status,depression status and RHDS score of the symptom group severity(P＜0.05).Multiple stepwise regres-sion analysis showed that age,course of disease,anxiety status,depression status and RHDS score were independent factors in-fluencing the severity of symptom group(P＜0.05).The scores of postoperative symptom groups were negatively correlated with RHDS scores(P＜0.05).Conclusion The high incidence of postoperative symptoms in elderly patients with lumbar disc herniation is pain,sleep disturbance,numbness,lethargy and distress.The symptom groups mainly include neurological symp-tom group,fatigue symptom group,emotional symptom group and gastrointestinal symptom group.Age,course of disease,anxiety status,depression status and RHDS score may be independent influencing factors for the severity of symptom group.It is necessary to find relevant symptoms as early as possible,formulate corresponding preventive measures,and improve the prognosis of patients.