文章摘要
段丹,宁宁,王艳琼,李佩芳,陈佳丽.全髋关节置换术后病人报告结局的现状与影响因素分析.骨科,2019,10(2):150-153
全髋关节置换术后病人报告结局的现状与影响因素分析
Analysis of patient reported outcome status and influencing factors after total hip arthroplasty
投稿时间:2018-07-02  
DOI:10.3969/j.issn.1674-8573.2019.02.014
中文关键词: 关节成形术,置换,髋  病人报告结局  影响因素
英文关键词: Arthroplasty, replacement, hip  Patient-reported outcome  Influencing factors
基金项目:四川大学华西医院学科卓越发展135工程项目(ZY2016204)
作者单位E-mail
段丹 四川大学华西医院骨科成都 610041  
宁宁 四川大学华西医院骨科成都 610041 gkningning@126.com 
王艳琼 四川大学华西医院骨科成都 610041  
李佩芳 四川大学华西医院骨科成都 610041  
陈佳丽 四川大学华西医院骨科成都 610041  
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中文摘要:
      目的 调查全髋关节置换术(total hip arthroplasty, THA)术后病人报告结局(patient-reported outcome, PRO)的现状,并对其影响因素进行分析。方法 采用自制病人一般资料调查表和髋关节残疾与骨关节炎评分(hip disability and osteoarthritis outcome score, HOOS)问卷,对我院2017年3月至2017年10月符合纳入与排除标准的病人进行横断面调查,收集并分析病人出院时的HOOS评分。以PRO得分为因变量,以性别、年龄、文化水平等自变量进行单因素分析;再以影响PRO得分的单因素为自变量,进行多重线性回归分析;分析影响PRO得分因素。结果 剔除4例,最终264例THA病人纳入本研究(264/268,98.51%);其中男142例,女122例;年龄为(54.95±13.47)岁(20~84岁)。264例THA术后病人出院时的HOOS总分为(226.41±33.59)分,其中疼痛维度为(68.75±8.73)分、症状维度为(78.94±8.94)分、日常生活活动能力维度为(43.16±7.39)分、运动和娱乐活动维度为0分、髋关节相关生活质量维度为(35.57±19.80)分。单因素分析结果显示,性别、入院方式、再入院次数、入院时疼痛程度和出院时疼痛程度均为影响PRO的因素,差异均有统计学意义(P均<0.05);多重线性分析结果显示,性别、入院方式、再入院次数、入院时疼痛程度和出院时疼痛程度均为THA术后PRO的影响因素(P均<0.05)。结论 THA术后病人出院时PRO得分整体较低,性别、入院方式、再入院次数、入院时疼痛程度和出院时疼痛程度为THA术后PRO的影响因素。需优化围手术期镇痛方案,给予女性、依赖扶行或轮椅入院、多次入院的病人更多关注。
英文摘要:
      Objective To investigate the status of patient-reported outcome after total hip arthroplasty (THA) and analyze its influencing factors. Methods A cross-sectional survey of the patients undergoing THA in our hospital who met the inclusion and exclusion criteria from March 2017 to October 2017 was conducted using the general patient survey and hip disability and osteoarthritis outcome score (HOOS). The HOOS scores of the patients at the time of discharge were collected and analyzed. With the report outcome score as dependent variable and the questionnaire content as independent variable, the single factor analysis was carried out. Then the multiple linear regression analysis was carried out with the single factor affecting the PRO score as independent variable, and the factors affecting the PRO score were analyzed. Results Four patients were excluded, and 264 patients with THA were enrolled in this study finally (264/268, 98.51%), including 142 males and 122 females, aged from 54.95±13.47 years (20 to 84 years). The average total score of patient-reported outcome after THA was (226.41±33.59), the points of pain was (68.75±8.73), the points of symptom was (78.94±8.94), the points of daily living activity was (43.16±7.39), the points of sports and recreational activities was zero and the points of hip-related quality of life was (35.57±19.80). Univariate analysis showed that gender, admission mode, number of re-admissions, degree of pain at admission and degree of pain at discharge were all single factors affecting PRO, with statistical significance (P<0.05). Multiple linear analysis showed that gender, mode of admission, number of re-admissions, degree of pain at admission and degree of pain at discharge were all factors affecting the PRO after THA (all P<0.05). Conclusion The overall score of patient-reported outcome after undergoing THA is low at the time of discharge. And the results showed that gender, admission method, the number of re-hospitalization, and the degree of pain at admission and discharge were the influencing factors of PRO after THA. To improve PRO after THA, medical staff should optimize the patient's perioperative analgesia program, pay more attention to women and patients who rely on supporting or wheelchair and are re-hospitalization.
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