目的 分析农村地区留守老年膝骨性关节炎患者心理因素对膝关节置换术后疼痛的影响.方法 收集49例(49膝)行膝关节置换术的留守老年膝骨性关节炎患者.记录患者人口统计学资料,使用焦虑抑郁量表(HAD)评估患者术前心理状态,视觉模拟评分法(VAS)评估患者术前术后疼痛程度,美国膝关节协会评分法(KSS)评估患者术前术后膝关节及膝关节功能指标.结果 术前通过HAD评分评估有20例患者纳入心理组,29例患者纳入对照组.2组VAS评分术前及术后3天相比差异无统计学意义(P>0.05),术后第7天、1个月及6个月2组相比差异具有统计学意义(P<0.05).2组膝关节及膝关节功能KSS评分术前相比差异无统计学意义(P>0.05).术后3个月及6个月膝关节及膝关节功能KSS评分比较,差异有统计学意义(P<0.05).结论 留守老年患者术前存在焦虑、抑郁心理障碍,术后手术部位疼痛程度较无心理障碍患者为重,且膝关节功能恢复较无心理障碍患者差.%Objective To analyze the influence of preoperative psychological factors on the pain after total knee joint arthroplasty(TKA) in rural left-behind elderly.Methods Totally 49 cases rural left-behind elderly patients were selected between January 2015 and January 2016.Collected the demographic data, evaluated the preoperative psychological state by the Hospital Anxiety and Depression Scale(HAD), Counted the preoperative and postoperative pain with the Visual analogue scale (VAS), the American Knee Society score (KSS) assessment of patients before and after operation of knee joint function.Results In the mental group(20 cases), preoperative and postoperative 3 days VAS scores were no statistic difference between two groups(P>0.05).However, postoperative 7 days, postoperative 1 month and postoperative 6 months both two groups was statistically significant(P<0.05) for VAS.There was no significant difference in preoperative KSS score between the two groups (P>0.05), but postoperative 3 months and postoperative 6 months two groups was statistically significant(P<0.05) for KSS.Conclusion If rural left-behind elderly patients with anxiety and depression before operation, it means there were poor pain and function after surgery, and it is necessary to take effective measures to establish effective strategy in prevention and treatment.
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