青少年特发性脊柱侧凸患者术后生活质量的影响因素分析

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[目的]分析各因素对青少年特发性脊柱侧凸患者术后生活质量的综合影响,为提高患者生活质量提供参考。[方法]选择2011年1月~2015年1月在本院手术的青少年特发性脊柱侧凸患者79例,之前均未接受任何治疗,详细统计患者性别、年龄、居住地、胸弯Cobb角、腰弯Cobb角、冠状面C_7铅垂线与骶骨正中线距离、矢状面C_7铅垂线与骶骨后上角距离、顶椎旋转度、双肩平衡等,采用SRS-30生活质量问卷进行评估,而后用多重线性回归模型预测各因素与青少年特发性脊柱侧凸患者术后生活质量的相关性。[结果]患者术后均获得不同程度改善,术后胸弯Cobb角平均20.7°,腰弯Cobb角平均12.8°,双肩高度差平均6.8 mm,C_7PL-CSVL平均13.7 mm,SVA平均22.9 mm,术后患者生活质量总分128.3分,各维度平均得分分别为疼痛(4.53)、心理(4.46)、功能/活动(3.73)、自我形象(4.28)、满意度(4.45)。男性患者在功能/活动维度(P=0.05)及满意度(P=0.037)上得分显著高于女性患者,城乡患者间得分无明显差异。[结论]不同影响因素对SRS-30问卷各个维度的影响权重各异,青少年特发性脊柱侧凸患者术后的生活质量是各个因素综合作用的结果。 [Objective] To analyze the comprehensive effect of various factors on postoperative quality of life of adolescent idiopathic scoliosis, and provide reference for improving the quality of life of patients. [Methods] From January 2011 to January 2015 in our hospital 79 cases of adolescent idiopathic scoliosis patients, have not received any treatment before, a detailed statistics of patient sex, age, place of residence, chest Cobb angle , Cobb angle of lumbar curve, distance between C_7 plumb line of coronal plane and midline of sacrum, distance between plumb line of Sagittal plane C_7 and posterior upper corner of vertebra, rotation of apex vertebra and balance of both shoulders were evaluated by SRS-30 Quality of Life Questionnaire , Then using multiple linear regression model to predict the relationship between various factors and postoperative quality of life in adolescent idiopathic scoliosis. [Results] The patients achieved various degrees of postoperative improvement. The average Cobb angle of chest flexion was 20.7 °, the average Cobb angle of lumbar curve was 12.8 °, the height difference of shoulders was 6.8 mm, the average C7PL-CSVL was 13.7 mm, the average SVA was 22.9 mm The total quality of life after the patient was 128.3 points. The average scores of each dimension were pain (4.53), psychology (4.46), function / activity (3.73), self-image (4.28) and satisfaction (4.45). Male patients scored significantly higher scores in functional / activity dimensions (P = 0.05) and satisfaction (P = 0.037) than in female patients, with no significant difference between urban and rural patients. [Conclusion] Different influencing factors have different weights on different dimensions of SRS-30 questionnaire. The quality of life of adolescent idiopathic scoliosis patients is the result of the combined effect of various factors.
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