冠状动脉旁路移植术后慢性疼痛发生率及其相关因素  

Incidence and risk factors of chronic post-operative pain syndrome after coronary artery bypass

作　　者：沈蓓[1] 金毅[1] 刘红军[1] 段满林[1] 徐建国[1] 

机构地区：[1]南京大学医学院临床医院南京军区南京总医院麻醉科,210002

出　　处：《临床麻醉学杂志》2010年第7期573-575,共3页Journal of Clinical Anesthesiology

摘　　要：目的了解冠状动脉旁路移植术(CABG)后患者开胸术后慢性疼痛综合征(PTPS)的发生率,对其可能影响因素进行相关分析。方法选取本院CABG后62例患者,复习病历以了解患者基本情况、术前疼痛情况、麻醉情况、手术情况及术后情况;根据简明疼痛问卷和语言评价量表(VRS)评分对患者慢性手术后疼痛情况进行电话回访。结果最终完成调查患者共计54例,PTPS的发病率为53.70%,其中胸骨切口愈合部位针刺样疼痛5例、烧灼样疼痛8例及胀痛17例,伴有局部皮肤疼痛敏感12例。疼痛症状持续和/或间断出现1年14例,2年9例,3年6例。PTPS与循环辅助时间、手术时间、主动脉阻断时间、术后3 d疼痛程度、术后心绞痛显著正相关;与术毕是否实施镇痛显著负相关。结论手术时间、术后急性疼痛和术后心绞痛是导致PTPS的危险因素。术后3年,发生率逐渐减低。Objective To study the incidence and risk factors of chronic post-operative pain syndrome（PTPS） after coronary artery bypass grafting（CABG）. Methods A questionnaire was sent to 62 patients underwent CABG. Data of basic situation, preoperative pain, anesthesia conditions, surgical conditions and postoperative situation, and chronic pain were collected and VRS scoring was performed on the phone. Results Fifty-four cases were included in the study. Incidence of chronic pain was 53.70%. Character of pain in sternal wound healing was needlelike pain（5 cases）, burning pain（8 cases） and acid-like pain（17 cases）, and 12 cases associated with local skin sensitivity. Pain, duration of symptoms and/or interruption,occurred as long as one year in 14 cases,2 years in 9 cases, 3 years in 6 cases. There was a significant positive correlation between PTPS and circulatory support time, operative time, aortic cross-clamping time, postoperative pain level, postoperative angina pectoris. There was a significant negative correlation between PTPS and analgesia after operation. Conclusion The risk factors for developing chronic pain after CABG are operative time, acute postoperative pain and postoperative angina pectoris. The incidence of CPSP gradually reduce with 3 years.

关 键 词：慢性手术后疼痛 开胸手术 冠状动脉旁路移植术 危险因素 回顾性研究 

分 类 号：R654.3[医药卫生—外科学]