术前抑郁症对椎手术结果的影响:系统性审查和元分析
Saad Javeed1, Salim Yakdan1, Braeden Benedict1
1Department of Neurological Surgery, Washington University, St. Louis, MO, USA.
Global spine journal
|January 24, 2025
概括
手术前的抑郁症没有显著改变椎手术后的功能改善. 然而,抑郁症患者在手术前和手术后都报告了更严重的疾病严重程度.
科学领域:
- 整形外科和脊椎外科手术
- 精神病学和心理健康 精神病学和心理健康
- 健康 结果 研究 研究 结果
背景情况:
- 术前抑郁症是经过椎手术的患者常见的并发症.
- 在椎脊椎手术后,抑郁症对患者报告的结果措施 (PROM) 的影响仍然不完全理解.
- 了解这些关联对于优化手术结果和患者护理至关重要.
研究的目的:
- 系统地审查和元分析手术前抑郁症和宫脊椎手术后的PROM之间的关联.
- 量化抑郁症对残疾,疼痛和身体功能变化的影响.
- 评估抑郁症对绝对疾病严重性的影响,手术前后.
主要方法:
- 在多个数据库 (PubMed,Cochrane,Embase,Scopus,PsychInfo,Web of Science,ClinicalTrials.gov) 中进行了系统的搜索.
- 包括比较患有抑郁症和非抑郁症的成年患者进行椎手术的PROM的研究.
- 随机效应元分析被用来合成来自20项纳入研究 (3964名患者) 的数据.
主要成果:
- 在抑郁和非抑郁患者之间的残疾,疼痛或身体功能改善的程度上没有发现统计学上显著的差异 (SMD = 0.04).
- 患有抑郁症的患者在手术前 (SMD = -0.31) 和手术后 (SMD = -0.31) 均表现出明显较差的绝对疾病严重程度.
- 在初级结果估计中观察到显著的异质性 (I2 = 81%),元回归确定年龄,性别,并发症,研究质量和外科手术方法作为来源.
结论:
- 患有抑郁症的患者在椎脊椎手术后的功能改善与没有抑郁症的患者相比.
- 尽管有类似的功能益处,但患有抑郁症的患者在整个手术过程中体验到更高的疾病严重程度负担.
- 这些发现强调了治疗椎手术患者的抑郁症的重要性,以管理整体疾病负担.
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