摘要
目的 探讨肝切除术后疼痛的发生情况及其影响因素.方法 回顾性分析555例行肝切除术患者的临床资料及术后疼痛发生情况,使用单因素分析及Logistic回归分析术后疼痛的相关影响因素.结果 本组555例行肝切除术的患者中,255例出现术后中重度疼痛,术后中重度疼痛发生率为45.95％.其中以切口疼痛最常见,性质以刀割样痛最多,原因以手术创伤为主,其次为术后并发症引起的疼痛.按是否发生术后疼痛分为术后疼痛组（n =255）和非术后疼痛组（n =300）,单因素分析显示2组差异有统计学意义的因素有年龄（t =3.435,P＜0.01）、手术史（x2=26.190,P＜0.01）、手术方式（x2=31.336,P ＜0.01）、切口长度（t=8.328,P＜0.01）、切除剑突（x2=19.423,P＜0.01）、切口最终结局（x2=311.535,P＜0.01）、并发症（x2=126.937,P＜0.01）.Logistic回归分析结果显示手术史（P =0.001）、手术方式（P =0.005）、切口长度（P =0.000）、切除剑突（P =0.001）、并发症（P =0.000）为术后疼痛的独立影响因素.结论 肝切除术后疼痛与既往手术史、手术方式、切口长度、是否切除剑突以及术后是否发生并发症有关.
Objective To investigate the occurrence of postoperative pain of hepatectomy and its possible related factors.Methods The clinical data of 555 cases undergoing hepatectomy was analyzed retrospectively,and the related influencing factors on postoperative pain of hepatectomy were analyzed by univariate analysis and multivariate logistic regression.Results Moderate postoperative pain was reported in 255 cases among 555 patients who underwent hepatic resection （with an incidence of 45.95％）.Incision pain which was often sharp was most common,followed by postoperative complication caused pain.According to whether the postoperative pain occurred or not,all cases were divided into postoperative pain group （n =255） and non-postoperative pain group （n =300）,univariate analysis showed that age （P ＜0.01）,surgical history （P ＜ 0.01）,surgical approach （P ＜ 0.01）,incision length （P ＜ 0.01）,xiphoid removal（P ＜ 0.01）,the final outcome of incision （P ＜ 0.01）,complications （P ＜ 0.01） were significantly different between the two groups.Logistic multiple regression analysis showed that the independent influencing factors of postoperative pain included surgical history （P =0.001）,surgical approach （P =0.005）,incision length （P =0.000）,xiphoid process removal （P =0.001）,complications （P =0.000）.Conclusions The postoperative pain of hepatectomy has a high incidence.Surgical history,surgical approach,incision length,xiphoid process,removal and postoperative complications are the independent impact factors of postoperative pain.
出处
《中华普通外科杂志》
CSCD
北大核心
2015年第3期194-197,共4页
Chinese Journal of General Surgery
基金
国家自然科学基金资助项目（81172364）
安徽省科技攻关基金资助项目（1301042199）
安徽省卫生厅医学科研重点基金资助项目（2010A006）
关键词
肝切除术
疼痛
手术后
Hepatectomy
Pain, postoperative
