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    邢贞武, 余德涛, 邢祯全, 王雷. 术前户外活动状态与腰椎管狭窄症病人行减压手术预后的相关性分析[J]. 蚌埠医科大学学报, 2019, 44(9): 1197-1201. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.015
    引用本文: 邢贞武, 余德涛, 邢祯全, 王雷. 术前户外活动状态与腰椎管狭窄症病人行减压手术预后的相关性分析[J]. 蚌埠医科大学学报, 2019, 44(9): 1197-1201. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.015
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    XING Zhen-wu, YU De-tao, XING Zhen-quan, WANG Lei. Correlation analysis of preoperative outdoor activity status and prognosis of lumbar spinal stenosis patients treated with decompression surgery[J]. Journal of Bengbu Medical University, 2019, 44(9): 1197-1201. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.015
    Citation: XING Zhen-wu, YU De-tao, XING Zhen-quan, WANG Lei. Correlation analysis of preoperative outdoor activity status and prognosis of lumbar spinal stenosis patients treated with decompression surgery[J]. Journal of Bengbu Medical University, 2019, 44(9): 1197-1201. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.015
    shu

    术前户外活动状态与腰椎管狭窄症病人行减压手术预后的相关性分析

    Correlation analysis of preoperative outdoor activity status and prognosis of lumbar spinal stenosis patients treated with decompression surgery

      摘要
    • 摘要:
      目的探讨腰椎管狭窄症（LSS）病人术前的户外活动水平与其手术减压后3个月和12个月疗效的相关性。
      方法收集99例行手术减压LSS病人临床资料，采用回顾性队列研究进行分析。依据其术前的户外活动情况，其中44例时常参加高强度或一般程度的户外活动，为有户外活动组，另55例为轻度户外活动或无活动的久坐状态，为无户外活动组。统计2组病人的人口学资料，以及术后3个月和12个月随访期间的预后情况，并进行相关性研究。
      结果与有户外活动组相比，无户外活动组病人的每日吸烟率较高（P < 0.05），非胰岛素依赖型2型糖尿病比例也相对较高（P < 0.05）。2组术后取得较好疗效（P < 0.01），但3个月时，无户外活动组病人腿痛VAS评分和Oswestry功能障碍指数（ODI）的改善程度均明显差于有户外活动组（P < 0.01）；术后12个月时，2组疗效差异无统计学意义（P>0.05）。多变量分析显示，患有抑郁症，体质量指数（BMI）为25.0~29.9 kg/m2、30.0~34.9 kg/m2、≥ 35.0 kg/m2的病人术前腰痛更严重（P < 0.05）；有户外活动的病人术前功能障碍相对较轻（P < 0.05~P < 0.01），生活质量相对较高（P < 0.05）。有户外活动的LSS病人在减压手术后12个月时ODI改善更为显著（P < 0.05）。
      结论术前无户外活动的LSS病人在腰椎减压手术后的早期恢复时间较长，但术后12个月亦会达到理想的疗效。

       

      Abstract:
      ObjectiveTo investigate the correlation between the level of outdoor activity before operation and efficacy after 3 and 12 months of decompression in patients with lumbar spinal stenosis(LSS).
      MethodsThe clinical data of 99 LSS patients treated with surgical decompression were retrospectively analyzed.According to the outdoor activities before operation, the patients were divided into the outdoor activity group(44 cases with regular participating in high intensity or moderate level of outdoor activities) and non-outdoor activity group(55 cases with mild outdoor activity or inactive sedentary state).The demographic data and prognosis after 3 and 12 months of operation in two groups were analyzed, and the correlation between two groups was studied.
      ResultsCompared with the outdoor activity group, the daily smoking rate and non-insulin dependent type 2 diabetes mellitus in non-outdoor activity group were higher(P < 0.05).The postoperative effects in two groups were better(P < 0.01), the improvement of VAS score and ODI index of leg pain in non-outdoor activity group were significantly lower than those in outdoor activity group(P < 0.05), and the difference of the treatment effect after 12 months of operation was not statistically significant(P>0.05).The results of multivariate analysis showed that the preoperative low back pain in patients with depression, BMI for 25.0-29.9, BMI for 30.0-34.9 and BMI for ≥ 35.0 kg/m2 were more severe(P < 0.05).The preoperative dysfunction and quality of life in patients with outdoor activities were lighter and higher, respectively(P < 0.05 to P < 0.01).The ODI index in LSS patients with outdoor activities were significantly improved after 12 months of decompression surgery(P < 0.05).
      ConclusionsThe early recovery time in LSS patients without outdoor activities before lumbar decompression surgery is long, but the desired outcome can be achieved after 12 months of surgery.

       

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