老年颅内动脉瘤患者术后生活质量与应对方式的相关性及影响因素

Correlation between postoperative quality of life and coping style in elderly patients with intracranial aneurysm and its influencing factors

【摘要】目的 探讨老年颅内动脉瘤患者术后生活质量与应对方式的相关性及影响因素。方法 回顾性分析2021年3月至2023年5月南京医科大学第一附属医院收治的140例行手术治疗的老年颅内动脉瘤患者的临床资料,患者在术前术后均采用社会应对方式问卷评估其应对方式,采用生活质量调查表(QLQ-C30)评估其生活质量。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。采用Pearson相关性分析生活质量与应对方式的相关性,采用logistic回归分析影响老年颅内动脉瘤患者术后生活质量的影响因素。结果 老年颅内动脉瘤患者术后生活质量总分、社会功能、情绪功能、角色功能、认知功能、躯体功能及应对方式中面应对应对得分均较术前升高(均P＜0.05),应对方式中回避、屈服应对得分均较术前降低(均P＜0.05)。经相关性分析发现,老年颅内动脉瘤患者生活质量与面对应对呈正相关,与回避、屈服应对呈显著负相关(r=0.840、-0.646、-0.487；均P＜0.05)。多因素logistic回归分析发现,手术方式为夹闭(OR=3.912,95%CI 1.406～10.882)、动脉瘤位置后循环(OR=4.811,95%CI 1.348～17.168)、术后并发症(OR=3.939,95%CI 1.405～11.045)、动脉瘤直径＞25mm(OR=4.948,95%CI 1.376～17.794)、Hunt-Hess评分Ⅲ级(OR=4.336,95%CI 1.291～14.560)、消极应对方式(OR=4.581,95%CI 1.304～16.093)是影响老年颅内动脉瘤患者术后生活质量的独立危险因素(P＜0.05)。结论 老年颅内动脉瘤患者生活质量与应对方式呈显著相关,且手术方式为夹闭、动脉瘤位置后循环、术后并发症、动脉瘤直径＞25mm、Hunt-Hess评分Ⅲ级、消极应对方式是影响老年颅内动脉瘤患者术后生活质量的独立危险因素,需引起重视,并采取措施积极管理。

基金项目:江苏省科技项目基础研究计划自然科学基金面上项目(BK20221418)

【Abstract】Objective To investigate the correlation between quality of life and coping style in elderly patients with intracranial aneurysm after operation and the influencing factors. Methods A retrospective study was conducted on 140 elderly patients with intracranial aneurysms undergoing surgical treatment in our hospital from March 2021 to May 2023. The coping styles of the patients were assessed by social coping style questionnaire, and their quality of life was assessed by quality of life questionnaire core 30 (QLQ-C30) before and after surgery. SPSS statistics 20.0 was used for statistical analysis. Data comparison between two groups was performed using t-test orχ² test depending on data type. Pearson correlation analysis was used to analyze the correlation between quality of life and coping style, and logistic regression was employed to analyze the influencing factors for postoperative quality of life in elderly patients with intracranial aneurysm. Results After treatment, the total score of quality of life, scores of social function, emotional function, role function, cognitive function, and physical function, and face-to-face score in coping strategies were all higher, while the avoidance and yield scores in coping strategies were lower than the corresponding scores before operation (all P<0.05). Correlation analysis showed that the postoperative quality of life of the elderly patients with intracranial aneurysm was positively correlated with face-to-face coping, and negatively correlated with avoidance and yielding coping (r=0.840, -0.646, -0.487; P<0.05). Multivariate logistic regression analysis indicated that clamping as surgical treatment (OR=3.912,95%CI 1.406-10.882), posterior circulation aneurysm (OR=4.811,95%CI 1.348-17.168), postoperative complications (OR=3.939,95%CI 1.405-11.045), aneurysm diameter >25 mm (OR=4.948,95%CI 1.376-17.794), Hunt-Hess Grade Ⅲ (OR=4.336; 95%CI 1.291-14.560), and negative coping style (OR=4.581,95%CI 1.304-16.093) were independent risk factors affecting postoperative quality of life in elderly patients with intracranial aneurysm (P<0.05). Conclusion In elderly patients with intracranial aneurysms, their postoperative quality of life is significantly correlated with coping styles. Surgical treatment of clamping, having aneurysm at posterior circulation artery, postoperative complications, aneurysm diameter >25 mm, Hunt-Hess grade Ⅲ, and negative coping styles are independent risk factors affecting their postoperative quality of life. Clinicians should pay more attention to these factors and take measures actively.

This work was supported by the General Project of Natural Science Foundation for Basic Research of Jiangsu Province (BK20221418).