肝癌脊柱转移术后患者恐动症的现况调查及影响因素分析

摘要/Abstract

摘要： 目的探究肝癌脊柱转移患者术后恐动症的发生现况,分析其潜在的影响因素,为肝癌脊柱转移患者术后恐动症的防治提供研究基础。方法选取2021年11月—2023年1月于海军军医大学第三附属医院骨科治疗的69例肝癌脊柱转移术后患者,应用一般资料调查表、恐动症Tampa评分表(TSK)、疼痛视觉模拟评分量表(VAS)、一般自我效能感量表(GSES)和家庭关怀度指数问卷(APGAR)进行数据收集。随后利用单因素统计方法分析一般资料及各量表在内的相关因素是否在恐动症/非恐动症组间存在差异,并对存在统计学意义的相关因素进行多因素logistic回归分析,以探究肝癌脊柱转移术后患者发生恐动症的影响因素。结果肝癌脊柱转移患者术后恐动症发生率为39.13%。单因素分析显示,患者恐动症发生与术前疼痛持续时间长,术后疼痛程度高、自我效能低、家庭关怀度差之间存在正相关。经多因素logistic回归分析矫正混杂因素后,术前疼痛持续时间、术后疼痛程度高被认为是肝癌脊柱转移患者术后恐动症发生的危险因素,而自我效能高为保护因素(P<0.05)。结论肝癌脊柱转移术后患者恐动症发生率较高,且与较长的术前疼痛持续时间、较高的术后疼痛程度、较低的自我效能有关。在临床实践中应当重视对上述因素的早期发现和干预,对于防治该类患者术后恐动症发生、改善其预后具有重要的临床意义。

关键词: 肝癌, 脊柱转移, 恐动症, 影响因素

Abstract: Objective To explore the current situation of kinesiophobia in patients with postoperative spinal metastases of liver cancer, analyze the potential influencing factors of kinesiophobia, and provide a research basis for the prevention and treatment of kinesiophobia in patients with postoperative spinal metastases of liver cancer. Methods Sixty-nine postoperative patients with spinal metastases of liver cancer treated in the Department of Orthopedics, Third Affiliated Hospital of Naval Medical University from November 2021 to January 2023 were selected, and the General Information Questionnaire, Tampa Scale for Kinetophobia (TSK), Visual Analogue Scale for Pain (VAS), General Self-efficacy Scale (MCSQ) and Family Care Index Questionnaire (APGAR) were applied to collect relative data. Subsequently, single factor statistical methods were used to analyze whether general information and correlated factors differed between the kinesiophobia and non- kinesiophobia groups. We further use multifactorial logistic regression analysis on variables that have statistical significance in univariate analysis to investigate the factors influencing the development of kinesiophobia in patients with postoperative spinal metastases of liver cancer. Results The incidence of postoperative kinesiophobia in patients with spinal metastases was 39.13%. Univariate analysis showed a positive association between the occurrence of kinesiophobia and longer preoperative pain duration, higher postoperative pain level, lower self-efficacy, and poor family care among patients. After correction of confounding factors by multifactorial logistic regression analysis, longer preoperative pain duration and higher postoperative pain level were considered as risk factors for the occurrence of postoperative kinesiophobia in patients with spinal metastases of liver cancer, while high self-efficacy was a protective factor (P<0.05). Conclusion Higher incidence of kinesiophobia in patients with spinal metastases of liver cancer is associated with longer preoperative pain duration, higher postoperative pain level, and lower self-efficacy. Early detection and intervention of the above factors should be emphasized in clinical practice, which is of great clinical significance to prevent the occurrence of postoperative kinesiophobia and improve the prognosis of these patients.

Key words: Liver cancer, Spinal metastases, Kinesiophobia, Influencing factor

刘丽, 唐飞扬, 汪秉轩, 赵浩南, 连邱健, 陈凤梅. 肝癌脊柱转移术后患者恐动症的现况调查及影响因素分析[J]. 肝脏, 2025, 30(4): 467-470.

LIU Li, TANG Fei-yang, WANG Bing-xuan, ZHAO Hao-nan, LIAN Qiu-jian, CHEN Feng-mei. Current situations and influencing factors of kinesiophobia in patients with postoperative spinal metastasis of liver cancer[J]. Chinese Hepatolgy, 2025, 30(4): 467-470.

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