椎管减压术对老年椎管狭窄患者焦虑抑郁情绪及生活质量的影响

目的探讨显微内窥镜下行微创椎管减压术对老年椎管狭窄患者焦虑抑郁情绪及生活质量的影响。方法将112例老年椎管狭窄患者随机分为三组，A组58例，施以显微内窥镜行微创椎管减压术治疗，B组21例，进行开放手术治疗，C组给予保守治疗。观察1mo。于治疗前及治疗1mo末采用健康状况调查问卷评定生活质量，采用焦虑自评量表、抑郁自评量表评定焦虑抑郁状况，并进行对比分析。结果治疗1mo后随访A组患者健康状况调查问卷各因子评分均有所提高，并显著高于C组（P〈0．05或0．01），而生理机能、生理职能、躯体疼痛、健康状况、精力和社会功能因子分均显著高于B组（P〈0．01）。A、B两组抑郁自评量表总分及A组焦虑自评量表总分均较治疗前有显著下降（P〈0．01）；A组焦虑自评量表总分显著低于B组和C组（P〈0．01），A、B两组抑郁自评量表总分均显著低于C组（P〈0．01）。结论显微内窥镜下行椎管减压术能改善老年椎管狭窄患者的焦虑抑郁情绪，提高生活质量。

The influence of spinal canal decompression on anxiety-depresssion emotions and quality of life of senile patients with spinal canal stenosis

Objective To explore the influence of microendoscopy-assisted minimally-invasive decompression on anxiety-depression emotions and quality of life of senile patients with spinal canal stenosis（SCS）. Methods 112 SCS patients were randomly assigned to group A（n=58） receiving microendoscopy-assisted minimally-invasive decompression, group B（n=21） doing open surgery and group C （n=33） doing conservative treatment for one month. Before and after treatment Quality of life was assessed with the Short Form 36 Health Survey Questionnaire（SF-36）, anxiety-depression status with the Self-rating Depression Scale （SDS） and the Self-rating Anxiety Scale （SAS） and contrastive analysis conducted. Results After one-month treatment, each factor score of the SF-36 in group A all elevated to some extent and was significantly higher than in the group C（P〈0.05 or 0.01）, and such factor score as physical functioning, role-physical, bodily pain, general health, vitality and social functioning than in the group B（P〈0.01）. Total score of the SDS of both group A and B and of the SAS of group A lowered more significantly compared with pretreatment （P〈0.01）. The total score of the SAS was significantly lower in group A than in B and C（P〈0.01） and those of group A and B than group C（P〈0.01）. Conclusion Microscope-assisted minimally-invasive decompression can improve anxiety-depression emotions and boost quality of life for senile patients with spinal canal stenosis.