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关节镜肩部稳定手术后新出现的焦虑和抑郁症的危险因素
David C Lutati1, Jane C Brennan1, Andrea H Johnson1
1Luminis Health Anne Arundel Medical Center, Annapolis, MD, USA.
JSES international
|February 9, 2026
概括
新发性焦虑或抑郁症 (NOAD) 影响5.1%的患者在关节镜肩部稳定手术后. 风险因素包括年龄较大,女性性别,超流动性和手术前阿片类药物使用,导致并发症和成本增加.
科学领域:
- 整形外科手术 整形外科手术
- 精神病学是一个精神病学.
- 健康 结果 研究 研究 结果
背景情况:
- 肩部不稳定性很普遍,特别是在年轻的运动员中,往往需要手术干预.
- 关节镜肩部稳定是管理肩部不稳定的常见程序.
- 这种手术后新发性焦虑或抑郁症 (NOAD) 的发生率和影响仍未得到充分研究.
研究的目的:
- 为了确定在关节镜肩部稳定后NOAD的发生率.
- 为了确定与NOAD发展相关的风险因素.
- 评估NOAD对术后并发症的影响以及精神病学干预的潜在保护作用.
主要方法:
- 对PearlDiver国家数据库的回顾性分析.
- 纳入标准:没有先前的抑郁症/焦虑症诊断或抗抑郁药的使用,以及至少1年的术后随访.
- 多变量逻辑回归和倾向得分匹配用于分析预测因素并比较结果.
主要成果:
- 在38,388名患者中,5.1%的患者在术后一年内发展出NOAD.
- NOAD的危险因素包括年龄增长,女性性别,高流动性,肥胖,手术前使用阿片类药物,吸烟和酒精障碍.
- NOAD与增加的90天再入院,长期使用阿片类药物,更高的成本和更高的修订率有关;心理治疗显示出潜在的益处.
结论:
- NOAD是在关节镜肩部稳定后的一个显著的术后并发症,影响大约5%的患者.
- 几种可识别的风险因素可以帮助患者对NOAD风险进行分层.
- 需要进一步的研究来开发缓解NOAD不良影响的干预措施.
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