摘要
【目的】探讨胸腔镜辅助开胸手术术后慢性疼痛的影响因素。【方法】收集2012年1月至2015年1月于本院行胸腔镜辅助开胸手术患者180例临床资料。采集患者术前和术中有关临床指标及术后急性疼痛评估和术后资料及出院后疼痛随访情况。对上述影响术后慢性疼痛形成的各项因素行单因素和Logistic回归分析。【结果】共纳入180例行胸腔镜辅助开胸手术患者，164例患者完成了术后3个月的随访，根据其手术术后是否发生慢性疼痛分为观察组和对照组。两组在性别比例、循环辅助时间、主动脉阻断时间、手术时间、术后镇痛及术后d1～5静息及活动时疼痛程度NRS评分等方面比较，差异均有统计学意义（P〈0．05）；而两组在年龄、体质量指数、既往吸烟、既往饮酒、术中芬太尼用量、胸腔闭式引流时间及术后住院时间等方面，差异无统计学意义（P〉0．05）；Logistic回归分析结果显示：女性，术后镇痛，术后d1～5活动时疼痛程度是胸腔镜辅助开胸手术术后慢性疼痛的重要影响因素。【结论】胸腔镜辅助开胸手术术后d1～5活动时疼痛程度是术后慢性疼痛最重要的可预防因素，术后积极控制急性疼痛可能有助于降低术后慢性疼痛的发生。
[Objective]To discuss the influencing factors of chronic pain in patients after thoracotomy via tho- racoscope. [Methods]One hundred and eighty patients treated by thoracotomy via thoracoscope in our hospital from January, 2012 to January, 2015 were chosen as the study subjects. The pre-operation data, data during oper- ation, pre-operation acute pain assessment, and post-operation and follow-up status on pain post-discharge were analyzed. The influencing factors of patients with chronic pain after thoracotomy via thoracoscope were analyzed by single factor and Logistic regression analysis. ~ResultslOne hundred and eighty patients treated by thoracotomy via thoracoscope were brought into the study~ 164 patients finished the 3 months follow-up and were divided into an observation group and a control group according to the presence or lack of chronic pain after thoracotomy via thora- coscope. Some differences in data between two groups were statistically significant （ P 〈0.05）. This data included sex ratio, time of circulation assistance and aorta occlusion, time of operation, postoperative analgesia, NRS score at rest and during activity 1~5 days after surgery, and so on. Other differences of data between two groups were not statistically significant （ P 〉0.05）. These included age, I3MI, smoking, drinking, dosage of fentanyl during surgery, time of thoracic close drainage, and hospital stays after surgery. The results of Logistic regression analy- sis showed that being female, receiving postoperative analgesia, and the pain degree during activity 1~5 days after surgery were the significant influence factors for patients with chronic pain after thoracotomy via thoracoscope. [Conclusion]Pain degree during activity 1~5 days after surgery is the most preventable factor for chronic pain af- ter surgery. The control of acute pain after surgery can help to reduce the occurrence of chronic pain after surgery.
出处
《医学临床研究》
CAS
2016年第5期853-856,共4页
Journal of Clinical Research
