摘要
为了探索全膝关节置换术(total knee artarthroplasty, TKA)对伴随夜间痛或抑郁症的终末期膝关节骨性关节炎(knee osteoarthritis, KOA)患者膝关节功能及生活质量的影响。通过回顾性分析2018年1月至2020年6月于邯郸市中心医院骨五科行初次TKA手术的195名患者资料。根据术前是否伴随夜间痛、抑郁症将患者分为夜间痛组(A组)、无夜间痛组(B组),抑郁症组(C组)、无抑郁症组(D组),研究了各组术前、术后6周、3月、1年患者的夜间痛发病率、疼痛程度、抑郁症发病率;术前、术后1年各组膝关节功能状态、生活质量。使用VAS评分(visual analog scale, VAS)评估疼痛程度,流调中心抑郁量表(center for epidemiological studies depression scale, CESD)评估抑郁程度,西安大略麦克马斯特大学骨关节炎指数(Western Ontario and McMaster University Osteoarthritis Index, WOMAC)和简明健康量表(12-item short form survey, SF-12)评估膝关节功能、生活质量。结果表明术前患者膝关节夜间痛的发生率为63.6%,抑郁症的发病率为17.9%。术前A组WOMAC,SF-12评分显著低于B组,差异有统计学意义,术后1年差异无统计学意义。术前C组WOMAC, SF-12评分显著低于D组,差异有统计学意义,术后1年差异无统计学意义。可见终末期KOA患者夜间痛、抑郁症发病率较高,伴随较差的膝关节功能及生活质量,TKA可以改善上述不适。
Inorder to document the advanced knee osteoarthritis patients with night pain and depressive disorder undergoing TKA(total knee artarthroplasty)and to determine whether the specific coexisting pain and/or disorder at the time of TKA adversely affected postoperative outcomes.Retrospective evaluation was used to investigate 195 patients undergoing TKA from January 2018 to June 2020 in the fifth orthopedic department of Handan Central Hospital.The patients were divided into night pain group(Group A)/non-night pain group(Group B)and depressed disorder group(Group C)/non-depressed disorder group(Group D)seperatly,preoperative and postoperative 6 weeks,3 months,1 year the prevalence of night pain,volume of pain,the prevalence of depressive disorder were examined in subgroup analyses,valued the function of knee and quality of life.The valume of night pain were analysised by visual analog scale(VAS)and depressive disorder using CESD(center for epidemiological studies depression scale).In addition,WOMAC(Western Ontario and McMaster Universities Osteoarthritis Index)and 12-item short form survey(SF-12)scores were assessed for knee function and life qualities.The results show that 63.6%of patients reported night pain,and the prevalences of depressive disorder was 17.9%,preoperatively,respectively.Preoperatively,compared with Group B,those with night pain(Group A)had significantly poorer preoperative WOMAC scores,but no significant difference was seen between groups 1 year after TKA.Preoperatively,the WOMAC,SF-12 scores of patients with depressive disorder(Group C)were significantly poorer than those of without depressive disorder(Group D),and there was no difference in clinical outcome scores 1 year after TKA between these groups.This study revealed a considerable prevalence of night painand depressive disorder in patients undergoing TKA and that patients with these specific conditions reported poorer functional and quality of life scores preoperatively.It is concluded that TKA can provide satisfactory outcomes for patients with these specific conditions.
作者
颜珍珍
袁宇飞
张存
李冠军
刘婷婷
李媛媛
谢洋
苗洁
YAN Zhen-zhen;YUAN Yu-fei;ZHANG Cun;LI Guan-jun;LIU Ting-ting;LI Yuan-yuan;XIE Yang;MIAO Jie(Department of the Fifth Orthopedic,Handan Central Hospital,Handan 056001,China;Department of the Sixth Orthopedic,Handan Central Hospital,Handan 056001,China;Department of the Surgery,Handan Central Hospital,Handan 056001,China)
出处
《科学技术与工程》
北大核心
2024年第6期2293-2297,共5页
Science Technology and Engineering
基金
河北省卫生厅课题(20220558)。
关键词
夜间痛
抑郁症
全膝关节置换术
临床结果
night pain
depressive disorder
total knee arthroplasty
clinical outcome
