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术前抑郁症对腰椎手术结果的影响:系统性审查和元分析

Saad Javeed¹, Braeden Benedict¹, Salim Yakdan¹

¹Department of Neurological Surgery, Washington University, St Louis, Missouri.

JAMA network open

|January 26, 2024

概括

经过腰椎手术的抑郁症患者表现出明显的疼痛和功能恢复潜力,尽管手术前疾病严重程度较差. 对抑郁症和脊柱残疾的进一步研究是有必要的.

科学领域:

整形外科整形外科整形外科
神经外科神经外科
精神病学是一个精神病学.

背景情况:

伴随性抑郁症在退行性腰椎病患者中很普遍.
抑郁症对腰椎脊椎手术结果的影响尚未完全理解.

研究的目的:

为了调查手术前抑郁症和腰椎手术后患者报告的结果措施 (PROMs) 之间的关联.

主要方法:

在多个数据库 (PubMed,Embase,Scopus等) 进行系统的文献搜索. 在2023年9月之前.
44项涉及21,452名患者的研究的元分析,评估PROMs的残疾,疼痛和身体功能.
进行元回归分析以确定影响异质性的因素.

主要成果:

患有抑郁症的患者在手术前和手术后的疾病严重程度 (残疾,疼痛,功能) 更差.
在手术后的抑郁和非抑郁患者之间,PROMs改善的幅度没有显著差异.
年龄,性别,并发症百分比和随访消耗是变异的重要来源.

结论:

患有抑郁症的患者在腰椎手术后,在残疾,疼痛和功能方面表现出显著的恢复潜力.
尽管基线严重程度较差,但抑郁症患者的改善程度与非抑郁症患者相比相当.
需要进一步研究脊柱残疾与抑郁症之间的联系,以及术后心理健康干预的作用.

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