创伤性脊髓损伤患者日常生活能力的影响因素分析

Analysis of influencing factors of daily living abilities in patients with traumatic spinal cord injury

中文关键词:  脊髓损伤  日常生活能力  影响因素  多元线性回归

英文关键词:Spinal cord injury  Ability of daily living  Influencing factors  Multiple linear regression analysis

中文摘要:

  【摘要】 目的：探讨创伤性脊髓损伤患者日常生活能力的影响因素。方法：选取2019年1月～2023年1月我院收治的148例创伤性脊髓损伤患者为调查对象进行横断面调查研究。收集患者性别、年龄、婚姻状况、损伤病程、损伤原因、损伤平面、美国脊髓损伤协会（American Spinal Injury Association，ASIA）残损分级（ASIA impairment scale，AIS）、手术情况及排尿方式等9个可能对日常生活能力产生影响的因素，采用脊髓独立性评定Ⅲ量表（spinal cord independence measure Ⅲ，SCIM-Ⅲ）评分评定创伤性脊髓损伤患者日常生活能力，用单因素分析各影响因素与日常生活能力的关系，应用多元线性回归分析影响因素对日常生活能力的影响。结果：单因素分析结果显示损伤平面、AIS、排尿方式对日常生活能力有显著性影响（P＜0.05），性别、年龄、婚姻状况、损伤病程、损伤原因、手术情况等无显著性影响。损伤平面中骶髓损伤患者日常生活能力最好，颈髓损伤患者日常生活能力最差。AIS中A级患者日常生活能力最差，E级患者日常生活能力最好。排尿方式中自行排尿患者日常生活能力最好，留置尿管/袋患者日常生活能力最差。自我照顾、呼吸和括约肌管理和移动维度及总分在不同损伤平面、AIS及排尿方式患者之间有统计学差异（P＜0.01）。多元线性回归分析结果显示，排尿方式、损伤平面、AIS是影响患者日常生活能力的主要因素。结论：损伤平面、AIS、排尿方式是影响创伤性脊髓损伤患者日常生活能力的主要因素，颈髓损伤、AIS A级、留置导管/袋的患者日常生活能力较差。

英文摘要:

  【Abstract】 Objectives: To explore the influencing factors of daily living abilities in patients with traumatic spinal cord injury. Methods: A cross-sectional study was conducted on 148 patients with traumatic spinal cord injury admitted to our hospital from January 2019 to January 2023. Factors that may affect the daily living abilities of patients were collected, including gender, age, marital status, course of injury, cause of injury, level of injury, American Spinal Injury Association(ASIA) impairment scale(AIS), surgical situation and urination pattern. The spinal cord independence measure Ⅲ(SCIM-Ⅲ) was used to evaluate the daily living abilities in patients with traumatic spinal cord injury. The relationship between the influencing factors and daily living abilities was analyzed by single factor analysis, and multiple linear regression was applied to analyze the impact of the influencing factors on daily living abilities. Results: Univariate analysis showed that the level of injury, AIS and, the urination pattern had significant effects on daily living abilities(P<0.05), while gender, age, marital status, course of injury, cause of injury, surgical situation had no significant effects on daily living abilities. With regard to the level of injury, patients with sacral spinal cord injury had the best daily living abilities, and patients with cervical spinal cord injury were the worst in daily living abilities. Regarding AIS, patients of level A were the worst in daily living abilities, and patients of level E were the best. In terms of urination pattern, patients who could spontaneous voiding were the best in daily living abilities, while those with indwelling catheter/bag had the worst daily living abilities. There were statistically significant differences in self-care, respiratory and sphincter management, movement and total scores between patients with different injury levels, urination patterns and AIS(P<0.01). Multiple linear regression showed that injury level, urination pattern and AIS were the main factors affecting the daily living abilities. Conclusions: The level of injury, AIS, and the urination pattern are the main factors affecting the daily living abilities of patients with traumatic spinal cord injury, and patients with injury of cervical cord, AIS level A, and indwelling catheter/bag have poor daily living abilities.