经皮脊柱内镜腰椎间盘切除术日间手术与住院手术患者SAS评分及SDS评分的比较研究OACSTPCD

Background The day surgery mode of percutaneous spinal endoscopic surgery is gradually being carried out in China.Few reports have been published on impacting patients'psychological status between day surgery and inpatient surgery modes.Objective To investigate the effects and differences of day and inpatient surgery modes on patients'psychological status after percutaneous spinal endoscopic surgery.Methods Clinical data about patients who underwent percutaneous endoscopic lumbar diskectomy from January 2020 to January 2023 in the Department of Orthopedics of the First Medical Center of Chinese PLA General Hospital were collected.Propensity score matching(PSM)was used to match patients in the day surgery and inpatient surgery group on a 1:1 basis.The preoperative and postoperative Zung self-assessment anxiety scale(SAS)score,Zung self-assessment depression scale(SDS)score,visual analog scale of lower limbs(VAS-L),visual analog scale of back(VAS-B),Japanese Orthopaedic Association(JOA)score and Oswestry disability index(ODI)were compared between the day surgery group and inpatient surgery group.Results After propensity score matching(PSM),50 patients were included in day surgery group and 50 cases in inpatient surgery group.In the day surgery group,there were 31 males and 19 females,with a mean age of(43.06±15.22)years and a mean disease duration of(20.39±38.41)months,while in the inpatient surgery group,there were 29 males and 21 females,with a mean age of(41.40±14.84)years and a mean disease duration of(22.27±40.38)months.Preoperatively,there was no statistically significant difference between the psychological scores and abnormality rates between the day and inpatient surgery groups(P＞0.05).Postoperatively,the SAS scores,SDS scores,and abnormality rates at all time points were better than preoperatively in both groups.The difference in SAS scores at discharge was statistically significant in the day surgery group compared with the inpatient surgery group(34.52±3.43 vs 36.58±4.52,P＜0.05),and the difference in the rate of abnormality in SAS scores was statistically significant(16%vs 34%,P=0.038);the difference in SAS scores at 1 week postoperatively was statistically significant(28.77±2.52 vs 31.18±3.17,P＜0.01);the differences in SAS scores,SDS scores and abnormality rates at other postoperative time points were not statistically significant(P＞0.05).In addition,the clinical efficacy at 3 months postoperatively was better than preoperatively in both groups;the difference in clinical efficacy at 3 months postoperatively between the two groups was not statistically significant(P＞0.05).Conclusion Anxiety and depression status of postoperative patients with PELD have been improved compared to preoperative in both inpatient and day surgery modes.Compared to the inpatient surgery modes,the percentage of patients who are in abnormal anxiety state in the short-term postoperative period is lower in the day surgery modes.