Factors Affecting the Quality of Life in Adolescent Scoliosis
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摘要:
目的 分析人口学参数和脊柱畸形测量参数间青少年脊柱侧凸（adolescent scoliosis，AS）患者在脊柱侧凸研究学会-22（scoliosis researth society-22，SRS-22）量表中疼痛、自我形象、功能状况和心理状况各维度得分的差异性及与之的相关性，了解AS患者的生活质量现状。 方法 收集2021年3月至2021年9月于昆明医科大学第二附属医院和云南（中德）骨科医院就诊的AS患者103例并完成SRS-22量表问卷，整理归纳所有研究对象的人口学资料和脊柱畸形测量数据，通过独立样本t检验、单因素方差分析、相关性分析SRS-22量表各维度得分间的差异性及与之的相关性。 结果 单弯与三弯、双弯与三弯在SRS-22量表功能状况维度上，差异有统计学意义（P < 0.05）；胸弯与双弯患者在SRS-22量表自我形象维度上，差异有统计学意义（P < 0.05）；胸弯与胸腰弯患者、胸弯与双弯患者在SRS-22量表心理状况维度上，差异有统计学意义（P < 0.05）；年龄与疼痛维度得分呈负相关（r = -0.328，P = 0.000）；主弯Cobb角分别与自我形象和心理状况维度得分呈负相关（r = -0.292，P = 0.003；r = -0.203，P = 0.039）；顶椎旋转度分别与自我形象和心理状况维度得分呈负相关（r = -0.295，P = 0.003；r = -0.236，P = 0.017）。 结论 年龄越大，AS患者的疼痛程度越严重；主弯顶椎位置不同的AS患者其自我形象感受也不同，顶椎位置越靠近胸段的个体，自我形象感受越糟糕；同时主弯Cobb角和顶椎旋转度越严重，AS患者的自我形象感受越差；不同的侧弯数量会造成个体的功能状况不同，侧弯曲线数量为三弯的患者功能状况感知最不佳；主弯Cobb角和顶椎旋转度越严重的患者，心理状况也最不良；因此了解AS患者的生活质量很有必要，相关工作人员需要根据不同情况的个体给予相对应的个性化治疗。 Abstract:Objective To analyze the differences and their correlations in the scores of pain, self-image, function and mental health of adolescent scoliosis （AS）between the demographic parameters and spinal deformity measurement parameters, and to understand the current quality of life of AS patients. Methods A total of 103 patients with scoliosis who were treated in the Second Affiliated Hospital of Kunming Medical University and Yunnan （Sino-German） Orthopaedic Hospital from March 2021 to September 2021 were collected and the SRS-22 questionnaire was conducted. Also, the demographic data and spinal deformity measurement data of all the subjects were sorted and summarized. The differences and correlation between the scores of various dimensions of SRS-22 were analyzed by independent sample t-test, one-way analysis of variance and correlation analysis. Results There was a statistically significant difference between AS and the normal female adolescents in the self-image （P < 0.001）; There were statistical differences in the self-image of the SRS-22 scale between the patients with thoracic and double major; There were statistical differences in the mental health of the SRS-22 between the patients with thoracic and thoracolumbar, and the patients with thoracic and double major; The age was negatively correlated with the pain （r = -0.328, P = 0.000）; There were statistically differences between the single curve and three curve, double curve and three curve in the function of SRS-22 scale （P < 0.05）. The apical vertebral rotation was negatively correlated with the self-image and mental health （r = -0.295, P = 0.003; r = -0.236, P = 0.017）; The Cobb angle of main curve was negatively correlated with the self-image and mental health （r = -0.292, P = 0.003; r = -0.203, P = 0.039）. Conclution Age may be an factor associated with the individual pain and the rotation of the apical vertebra and the Cobb angle of main curve may be the effecting factors of the self-image and mental health of AS. There are differences in the self-image and mental health of AS under the different apical vertebra positions. There are differences in the functional status of AS patients with different number of lateral bending curves. -
Key words:
- Adolescent scoliosis /
- SRS-22 questionnaire /
- Health related quality of life /
- Ethic
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图 1 汉族和少数民族AS患者SRS-22量表各维度得分
Figure 1. Scores of each dimension of SRS-22 scale in AS of Han and Ethnic
图 2 男性和女性AS患者SRS-22量表各维度得分
Figure 2. The scores of each dimension of the SRS-22 scale in male and female AS
图 3 不同侧弯曲线数量的AS患者SRS-22量表各维度得分
*P < 0.05。
Figure 3. The scores of each dimension of SRS-22 scale in AS patients with different number of scoliosis curve
图 4 不同顶椎位置的AS患者SRS-22量表各维度得分
*P < 0.05。
Figure 4. The scores of each dimension of SRS-22 scale in AS patients with different apical vertebrae positions
图 5 年龄与AS患者疼痛维度得分的相关性分析
Figure 5. Correlation analysis between age and pain dimension scores in with AS
图 6 顶椎旋转度与AS患者自我形象和心理状况维度得分的相关性分析
Figure 6. Correlation analysis between apical vertebra rotation and self-image and mental health dimension scores in AS
图 7 主弯Cobb角与AS患者自我形象和心理状况维度得分的相关性分析
Figure 7. Correlation analysis of the Cobb angle of main curve with the scores of self-image and mental health in AS
表 1 研究对象的一般情况（%）
Table 1. General information of all subjects （%）
变量 人数（n） 百分率 变量 人数（n） 百分率 性别 侧弯曲线数量 男 9 8.7 单弯 25 24.3 女 94 91.3 双弯 50 48.5 民族 三弯 28 27.2 汉族 80 77.7 主弯顶椎位置 少数民族 23 22.3 胸弯 40 38.8 顶椎旋转度 胸腰弯 18 17.5 0度 26 25.2 腰弯 20 19.4 1度 48 46.6 双弯 25 24.3 2度 23 22.3 主弯Cobb角严重程度 3度 4 3.9 10°～20° 19 18.4 4度 2 1.9 21°～40° 57 55.3 > 40 27 26.2 
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表 2 研究对象SRS-22问卷各维度得分（分）
Table 2. The scores of each dimension of the SRS-22 questionnaire of all subjects （Points）
SRS-22量表 疼痛 自我形象 功能状况 心理状况 得分 4.49 ± 0.44 3.42 ± 0.58 4.4 ± 0.47 3.87 ± 0.66
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表 3 相关性分析结果
Table 3. Correlation analysis results
参数 疼痛 自我形象 功能状况 心理状况 年龄 r = −0.328 r = −0.046 r = −0.066 r = −0.043 P = 0.000 P = 0.627 P = 0.490 P = 0.660 顶椎旋转度 r = 0.045 r = −0.295 r = −0.071 r = −0.236 P = 0.654 P = 0.003 P = 0.477 P = 0.017 主弯Cobb角 r = −0.001 r = −0.292 r = −0.185 r = −0.203 P = 0.992 P = 0.003 P = 0.061 P = 0.039
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