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  • 邵为,林涛,孟怡辰,仲海燕,书伦,姜横,马骁,王策,周许辉.青少年特发性脊柱侧凸患者支具治疗与抑郁程度的相关性研究[J].第二军医大学学报,2019,40(6):619-623    [点击复制]
  • SHAO Wei,LIN Tao,MENG Yi-chen,ZHONG Hai-yan,SHU Lun,JIANG Heng,MA Xiao,WANG Ce,ZHOU Xu-hui.Correlation between bracing treatment and depression severity in adolescent idiopathic scoliosis[J].Acad J Sec Mil Med Univ,2019,40(6):619-623   [点击复制]
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青少年特发性脊柱侧凸患者支具治疗与抑郁程度的相关性研究
邵为1,2,林涛1,孟怡辰1,仲海燕2,书伦1,姜横1,马骁1,王策1,周许辉1*
0
(1. 海军军医大学(第二军医大学)长征医院脊柱外科, 上海 200003;
2. 解放军359医院创伤外科, 镇江 212001
*通信作者)
摘要:
目的 评估青少年特发性脊柱侧凸(AIS)患者接受支具治疗后心理健康状况,观察AIS患者支具治疗前后抑郁程度的改变并分析其影响因素。方法 收集2013年1月至2015年1月于海军军医大学(第二军医大学)长征医院门诊接受支具治疗的AIS患者的一般资料及影像学资料,包括年龄、性别、体质量指数、支具治疗前及末次随访时冠状位主弯Cobb角,以及至末次随访时支具治疗的持续时间。应用流调中心儿童抑郁量表(CES-DC)、长处与困难问卷(SDQ)评估接受支具治疗前及末次随访时患者的抑郁程度及心理健康状况,并应用多元线性回归模型分析患者支具治疗过程中抑郁程度改变的影响因素。结果 共纳入112例AIS患者(男16例,女96例)。与支具治疗前相比,末次随访时患者的CES-DC评分增高(38.4±3.0 vs 26.1±4.2),SDQ中亲社会行为分量表评分降低(2.7±0.5 vs 4.2±0.3)、情绪问题和同伴问题2个分量表评分均增加(7.7±1.5 vs 5.3±2.2,7.6±1.4 vs 5.0±1.6),差异均有统计学意义(t=25.22、-27.22、9.54、12.94,P均<0.01)。多元线性回归分析提示,AIS患者抑郁程度与支具治疗前的冠状位主弯Cobb角、至末次随访时支具治疗的持续时间,以及支具治疗前SDQ中情绪问题与同伴问题分量表评分均呈正相关(P均<0.05),而与SDQ中亲社会行为分量表的评分呈负相关(P<0.01)。结论 AIS患者支具治疗后心理健康状况发生改变,抑郁程度升高;对于支具治疗前冠状位主弯Cobb角较大、支具治疗持续时间较长及支具治疗前SDQ情绪与同伴问题评分较高的患者,在治疗前给予积极的心理干预有望改善患者治疗后的生活质量。
关键词:  青少年特发性脊柱侧凸  支具  抑郁  精神卫生
DOI:10.16781/j.0258-879x.2019.06.0619
投稿时间:2018-10-22修订日期:2019-01-15
基金项目:国家自然科学基金(81772305).
Correlation between bracing treatment and depression severity in adolescent idiopathic scoliosis
SHAO Wei1,2,LIN Tao1,MENG Yi-chen1,ZHONG Hai-yan2,SHU Lun1,JIANG Heng1,MA Xiao1,WANG Ce1,ZHOU Xu-hui1*
(1. Department of Spine Surgery, Changzheng Hospital, Naval Medical University(Second Military Medical Unversity), Shanghai 200003, China;
2. Department of Trauma, No. 359 Hospital of PLA, Zhenjiang 212001, Jiangsu, China
*Corresponding author)
Abstract:
Objective To evaluate the mental health status of patients with adolescent idiopathic scoliosis (AIS) after bracing treatment, and to observe the severity of depressive symptoms and analyze the influencing factors. Methods We collected the general data and imaging data of AIS patients who underwent bracing treatment in the outpatient clinic of Changzheng Hospital of Naval Medical University (Second Military Medical University) from Jan. 2013 to Jan. 2015. The data included age, gender, body mass index, coronal main curve Cobb angle at the initial treatment and the last follow-up, and duration of bracing treatment. The Center for Epidemiological Studies depression scale for children (CES-DC) and the strengths and difficulties questionnaire (SDQ) were used to assess the severity of depression and the mental health status before bracing treatment and at the last follow-up. Multivariate linear regression model was used to analyze the factors influencing the severity of depression during the bracing treatment. Results A total of 112 patients (16 males and 96 females) were enrolled in our study. We found that the CES-DC score was significantly higher at the last follow-up than that at the beginning (38.4±3.0 vs 26.1±4.2); the scores of the emotional problems (7.7±1.5 vs 5.3±2.2) and peer problems (7.6±1.4 vs 5.0±1.6) in the SDQ were significantly increased and the score of the prosocial behavior was significantly decreased (2.7±0.5 vs 4.2±0.3) at the last follow-up (t=25.22, -27.22, 9.54 and 12.94; all P<0.01). Multivariate linear regression analysis suggested that the depression severity of AIS patients was positively correlated with the pre-treatment coronal main curve Cobb angle, duration of bracing treatment, and pre-treatment SDQ emotional symptom and peer problem scores (all P<0.05), but were negatively correlated with the score of the prosocial behavioral subscale of SDQ. Conclusion The mental health status of patients with AIS is changed after bracing treatment, with increased severity of depression. Active psychological intervention shall be given to patients with large pre-treatment coronal main curve Cobb angle, longer treatment time of bracing, and higher pre-treatment SDQ's emotional symptom scores and peer problem scores, which may improve the post-treatment quality of life of patients.
Key words:  adolescent idiopathic scoliosis  bracing  depression  mental health