慢性髋关节疼痛患者的功能障碍及相关心理因素分析

doi:10.3969/j.issn.1006-9771.2022.12.015

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (12): 1484-1488.doi: 10.3969/j.issn.1006-9771.2022.12.015

• 应用研究 • 上一篇

慢性髋关节疼痛患者的功能障碍及相关心理因素分析

张晓倓^1a(),李军^1a,张玲玲²,谢惠敏^1a,孙丽君^1b,潘昱^1c,李春宝^1d,贾子善^1a,张立宁^1a()

1.解放军总医院第一医学中心，a.康复医学科；b.骨科研究所；c.心理科；d.骨科，北京市 100853
2.河北师范大学体育学院，河北石家庄市 050010

收稿日期:2022-05-11 修回日期:2022-11-08 出版日期:2022-12-25 发布日期:2023-01-10
通讯作者: 张立宁 E-mail:zhangln301@163.com
作者简介:张晓倓(1987-)，女，汉族，山东菏泽市人，硕士，主管技师，主要研究方向：康复治疗；|李军(1978-)，女，河北唐山市人，硕士，主管技师，主要研究方向：康复治疗。|张立宁(1980-)，女，汉族，河北南宫市人，博士，副主任医师，副教授，硕士研究生导师，主要研究方向：运动损伤康复。
基金资助:
1.国家重点研发计划项目(2019YFB131140);2.军事创新医学项目(CX19005);3.全军后勤科研计划重大项目子项(AMS17J004)

Functional disorders and related psychological factors in patients with chronic hip pain

ZHANG Xiaotan^1a(),LI Jun^1a,ZHANG Lingling²,XIE Huimin^1a,SUN Lijun^1b,PAN Yu^1c,LI Chunbao^1d,JIA Zishan^1a,ZHANG Lining^1a()

1. a. Department of Rehabilitation Medicine; b. Institute of Orthopaedics; c. Department of Psychology; d. Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
2. College of Physical Education, Hebei Normal University, Shijiazhuang, Hebei 050010, China

Received:2022-05-11 Revised:2022-11-08 Published:2022-12-25 Online:2023-01-10
Contact: ZHANG Lining E-mail:zhangln301@163.com
Supported by:
National Key R&D Program(2019YFB131140);Military Innovative Medicine Program(CX19005);Scientific Research Program of General Logistics Department of PLA(AMS17J004)

摘要/Abstract

摘要：

目的分析慢性髋关节疼痛患者功能障碍的特点，阐明其功能障碍与心理因素之间的关系。

方法收集2021年4月至2022年3月解放军总医院收治的55例慢性髋关节疼痛患者(患者组)，34例健康受试者作为对照组。通过问卷调查采集患者一般人口学信息和临床资料。采用髋关节日常生活能力评分(HOS-ADL)、髋关节运动能力评分(HOS-SSS)、改良Harris髋关节评分(mHHS)、12项健康调查简表(SF-12)、视觉模拟评分(VAS)、医院焦虑抑郁量表(HADS)(分为HADS:A和HADS:D)、焦虑状态/特质问卷(STAI)、疼痛灾难化量表(PCS)、Pittsburgh睡眠质量指数(PSQI)进行评价，并分析与各项临床指标的相关性。

结果患者组mHHS、HOS-ADL、HOS-SSS、SF-12评分均显著低于对照组(|Z| > 6.251, P < 0.001)。mHHS、HOS-ADL、HOS-SSS、SF-12评分均与PCS评分呈负相关(|r| > 0.480, P < 0.01)。PCS的影响因素为HADS:A，HADS:D和HOS-ADL。

结论慢性髋关节疼痛患者功能水平与疼痛灾难化密切相关，而疼痛灾难化影响因素为焦虑、抑郁、髋关节日常生活所需的运动功能。

关键词: 慢性髋关节疼痛, 功能障碍, 疼痛灾难化量表, 焦虑, 抑郁

Abstract:

Objective To analyze the characteristics of dysfunction in patients with chronic hip pain and clarify the relationship between dysfunction and psychological factors.

Methods A total of 55 patients with chronic hip pain admitted to the First Medical Center, Chinese PLA General Hospital from April, 2021 to March, 2022 were selected as experimental group, and 34 healthy subjects were selected as control group. The basic information and clinical data were collected by questionnaire. They were evaluated with the Hip Outcome Score Activities of Daily Living (HOS-ADL), the Hip Outcome Score sport-specific subscale (HOS-SSS), modified Harris Hip Score (mHHS), the 12-Item Short-Form Health Survey (SF-12), Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS including HADS: A and HADS:D), State-Trait Anxiety Inventory (STAI) and Pain Catastrophizing Scale (PCS), and their corelation with clinical indicators were analyzed.

Results The scores of mHHS、HOS-ADL、HOS-SSS and SF-12 were significantly lower in the experimental group than in the control group (|Z| > 6.251, P < 0.001). The scores of mHHS, HOS-ADL, HOS-SSS and SF-12 were negatived related with the score of Pain Catastrophizing Scale (PCS) (|r| > 0.480, P < 0.01). The risk factors of PCS were HADS:A, HADS:D and HOS-ADL.

Conclusion The functional level of patients with chronic hip pain is closely related to the catastrophic pain, and the influencing factors of catastrophic pain are anxiety, depression, and the motor function required for daily life of the hip joint.

Key words: chronic hip pain, dysfunction, Pain Catastrophizing Scale, anxiety, depression

中图分类号:

R684.3

张晓倓,李军,张玲玲,谢惠敏,孙丽君,潘昱,李春宝,贾子善,张立宁. 慢性髋关节疼痛患者的功能障碍及相关心理因素分析[J]. 《中国康复理论与实践》, 2022, 28(12): 1484-1488.

ZHANG Xiaotan,LI Jun,ZHANG Lingling,XIE Huimin,SUN Lijun,PAN Yu,LI Chunbao,JIA Zishan,ZHANG Lining. Functional disorders and related psychological factors in patients with chronic hip pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(12): 1484-1488.

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参考文献 27

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组别	n	性别(男/女)/n	年龄/岁	BMI/kg·m^-2
对照组	34	17/17	51(28.25, 59.25)	24.35(20.40, 26.06)
患者组	55	23/32	40(31, 53)	22.58(20.31, 24.44)
Z/χ²值		-0.750	-0.887	-1.142
P值		0.453	0.375	0.156

组别	n	HOS-ADL	HOS-SSS	mHHS	SF-12
对照组	34	100(99, 100)	100(100, 100)	91(88, 91)	42(41, 43)
患者组	55	78(57, 91)	56(11, 72)	70(54, 78)	36(31, 39)
Z值		-7.775	-7.759	-7.162	-6.251
P值		< 0.001	< 0.001	< 0.001	< 0.001

项目	mHHS	HOS-SSS	HOS-ADL	SF-12
年龄	0.258	0.232	0.280^a	0.265
病程	-0.253	-0.272^a	-0.213	-0.083
BMI	0.205	0.319^a	0.326^a	0.216
HADS:A	-0.476^b	-0.303^a	-0.369^b	-0.522^b
HADS:D	-0.441^b	-0.219	-0.356^b	-0.423^b
PSQI	-0.153	0.084	-0.010	-0.122
S-Anxiety	0.097	-0.028	-0.006	-0.012
T-Anxiety	-0.071	-0.065	-0.092	-0.035
PCS	-0.577^b	-0.506^b	-0.577^b	-0.480^b
VAS	-0.071	-0.261	-0.284^a	-0.224

变量	β	S.E	t	P	95%CI
常量	12.015	5.088	2.361	0.022	1.801~22.229
HADS:A	1.264	0.322	3.928	0	0.618~1.910
HADS:D	0.679	0.311	2.185	0.033	0.055~1.303
HOS-ADL	-0.164	0.054	-3.061	0.004	-0.272~-0.057

慢性髋关节疼痛患者的功能障碍及相关心理因素分析

Functional disorders and related psychological factors in patients with chronic hip pain

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