目的: 调查腰椎间盘突出(lumbar disc herniation, LDH)患者腰椎融合术后恐动症现状, 分析LDH患者腰椎融合术后恐动症的影响因素。方法: 选择2021年1月至2022年12月在温州医科大学附属第二医院行腰椎融合术且术后第1天有效填写恐动症评分表(tampa scale for kinesiophobia, TSK)等调查问卷的489例LDH患者的病例资料, 进行回顾性分析, 采用恐动症评分表(tampa scale for kinesiophobia, TSK)调查LDH患者腰椎融合术后恐动症发生情况, 根据LDH患者腰椎融合术后是否存在恐动症分为恐动组(n=221)与非恐动组(n=268), 收集两组患者一般资料, 并运用Logistic回归分析LDH患者腰椎融合术后恐动症的危险因素。结果: 489例LDH患者221例(45.19%)存在腰椎融合术后恐动症, 其中男性(95%CI: 3.289~10.586, P＜0.001)、文化程度本科以下(95%CI: 6.533~45.162, P＜0.001)、重度疼痛(95%CI: 10.348~72.025, P＜0.001)、中度疼痛(95%CI: 6.247~37.787, P＜0.001)、低自我效能感(95%CI: 4.238~15.095, P＜0.001)、中自我效能感(95%CI: 2.804~8.643, P＜0.001)是LDH患者腰椎融合术后恐动症的影响因素(P＜0.05)。结论: LDH患者腰椎融合术后恐动症发生率较高, 其影响因素包括性别、文化程度、疼痛程度、自我效能感。

Objective: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. Methods: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. Results: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). Conclusion: The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.