周围神经病变的患病率和对移动性的影响 假肢处方后12个月 在患有血管性下肢截肢的人群中
Daniel C Norvell1,2, Elizabeth G Halsne1,2, Alison W Henderson1
1VA Puget Sound Health Care System, Seattle, Washington, USA.
PM & R : the journal of injury, function, and rehabilitation
|August 29, 2024
概括
周围神经病变 (PN) 在下肢截肢 (LEA) 后很常见,严重影响了运动能力. 抑郁症会加剧PN的情况.
科学领域:
- 整形外科和康复治疗
- 血管外科 血管外科
- 神经学 神经学
背景情况:
- 周围神经病变 (PN) 是下肢截肢 (LEA) 后的常见并发症,特别是在患有血管障碍的患者中.
- 在LEA后,PN对移动性和假肢使用的影响需要进一步调查,特别是考虑到潜在的抑郁症等改变因素.
研究的目的:
- 为了确定PN的患病率,在穿肢 (TT) 或穿肢 (TF) 截肢后,患者被处方下肢假肢 (LLP).
- 评估PN对这些患者移动性的影响.
- 调查截肢水平或抑郁是否会改变PN对移动性的影响.
主要方法:
- 通过退伍军人事务 (VA) 公司数据库 (CDW) 和国家假肢患者数据库,追溯识别了357名因糖尿病和/或外围动脉疾病而接受TT或TF截肢并接受LLP的患者.
- 通过邮件和电话收集前性数据,以使用Locomotor Capabilities Index (LCI) 获得自我报告的移动性.
- 采用多重逻辑回归分析来控制混因素和识别效果修饰因素.
主要成果:
- 在假肢处方之前,66%的参与者被诊断为PN.
- PN显著降低了实现基本和高级移动性的可能性 (aOR=0.53,P=.03;aOR=0.43,P=.005分别).
- 在患有抑郁症 (aOR=0.36,P=.04) 的患者中,与没有抑郁症 (aOR=0.53,P=.07) 的患者相比,PN对晚期运动的负面影响更为明显.
结论:
- 周围神经病变在患有血管障碍下肢截肢的患者中非常普遍,并显著损害了运动能力.
- 抑郁症似乎加剧了与PN相关的移动性限制,特别是在高级移动性任务中.
- 包括心理健康评估和治疗在内的有针对性的康复计划对于优化这种患者群体的流动性结果至关重要.
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