陈胜敏 罗慧利 陆海荣 郝秀芳 董学伟 宋艳丽

[摘要]目的：探討影响脊柱侧凸青少年手术意愿的相关因素。方法：选取2016年1月-2019年1月于笔者医院就诊的80例青少年脊柱侧凸患者为研究对象，根据手术意愿为积极手术组和不积极组，采用问卷调查方式收集两组患者临床资料，生活质量、社会支持度及社会心理因素等相关指标;并应用单因素和多因素Logistic回归模型分析影响患者手术意愿的独立相关因素。结果：积极手术患者为53例，占总患者数的66.25%。两组患者年龄、性别、受教育程度、患病时间、身体质量指数（Body mass index，BMI）比较，差异无统计学意义（P>0.05）。而自我形象、社会支持度、担忧手术并发症、自我认同比较，差异具有统计学意义（P<0.05）;Logistic回归分析结果显示，自我形象（OR=4.234）、社会支持度（OR=0.886）、担忧手术并发症（OR=7.334）、自我认同（OR=5.255）为影响脊柱侧凸青少年手术意愿的独立相关因素。结论：自我形象、社会支持度、担忧手术并发症和自我认同是影响青少年脊柱侧凸患者手术意愿的独立相关因素。

[关键词]脊柱侧凸;手术意愿;社会心理因素;自我形象;自我认同;焦虑;抑郁;并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）01-0146-03

Influencing Factors of Surgical Intention in Adolescent Patients with Scoliosis

CHEN Sheng-min，LUO Hui-li，LU Hai-rong，HAO Xiu-fang，DONG Xue-wei，SONG Yan-li

（Department of Spine，the Third Hospital of Hebei Medical University，Shijiazhuang 050051，Hebei，China）

Abstract： Objective  To explore the related factors influencing the surgical intention of adolescent scoliosis. Methods  Selected 80 adolescent scoliosis patients who were treated in our hospital from January 2016 to January 2019 as the research objects. According to the surgical wishes， they were divided into the active operation group and the inactive group. A questionnaire survey was used to collect the clinical results of the two groups. Data， quality of life， social support and social psychological factors and other related indicators; and apply single factor and multivariate Logistic regression models to analyze independent related factors that affect patients' willingness to operate. Results  There were 53 patients undergoing active surgery， accounting for 66.25% of the total number of patients. There was no statistically significant difference between the two groups of patients in age， gender， education level， illness time， and body mass index （BMI） （P>0.05）. The differences in self-image， social support， worry about surgical complications， and self-identity were statistically significant （P<0.05）. Logistic regression analysis showed that self-image （OR=4.234） and social support （OR=0.886）， worry about surgical complications （OR=7.334）， and self-identification （OR=5.255） were independent related factors that affected the willingness of scoliosis surgery in adolescents. Conclusion  Self-image， social support， worry about surgical complications， and self-identity are independent and relevant factors that affect the surgical willingness of adolescent scoliosis patients.

Key words： scoliosis; surgical intention; psychosocial factors; self-image; self-identity; anxiety; depression; complications

脊柱侧凸是指脊柱一个或多个节段向侧方弯曲或伴有椎体旋转的脊柱畸形，多见于青少年，据统计我国脊柱侧凸发病约为1.04%～1.20%，女性多于男性[1]。早期临床症状多不明显，随着青少年的生长发育侧凸也随之发展，严重可致患者出现呼吸困难及呼吸道感染。早期手术矫形治疗被视为青少年脊柱侧凸的有效的治疗手段[2]。但脊柱侧凸矫形手术创伤大，费用高昂，术中波及脊柱节段多，术后并发症发生率高在很大程度上降低青少年脊柱侧凸患者手术意愿。目前关于青少年脊柱侧凸患者积极手术意愿的影响因素尚不明确，少数研究指出[3-4]，心理因素可能会影响手术意愿。由于……