地震骨折伤员慢性疼痛的相关因素及与生活质量的关系  

Chronic pain-related factors and the quality of life of fracture victims 27 months after the Sichuan earthquake

作　　者：李咏雪[1] 张霞[1] 伊文超[1] 胡筱蓉[1] 肖明月[1] 金鸿[2] 励建安[1] 

机构地区：[1]南京医科大学第一附属医院康复医学科,南京210029 [2]绵竹市人民医院院办

出　　处：《中华物理医学与康复杂志》2011年第9期673-677,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨五一二四川地震27个月后骨折伤员慢性疼痛的相关因素和疼痛程度与生活质量的关系。方法回访705例四川省绵竹市五一二地震骨折伤员，按视觉模拟评分（VAS）分为无疼痛、轻度疼痛、中度疼痛和重度疼痛组。通过现场评估和问卷调查伤员手术和康复情况、情绪状态、职业和经济、巴塞尔指数（BI）、生活满意度问卷（LiSat-11）、简明健康调查（SF-36）量表，分析与疼痛有关的生物、心理和社会因素，并确定疼痛强度与生活质量的关系。结果五一二地震27个月后，骨折伤员慢性疼痛发生率为88．5％，其中轻度和中度疼痛分别占35．7％和33．3％。骨折手术率为65．8％，愈合率为96．9％。4组伤员B1分别为（92．7±10．2）分，（92．8±8．4）分，（91．2±9．9）分，（90．4±14．7）分，差异无统计学意义（P〉0．05）。疼痛程度对生活满意度的影响，差异呈线性趋势（P〈0．05）。4组伤员职业能力受到限制的比例分别为38．3％、61．5％、75．7％和62．8％；其家人的平均年收入用中位数（第1四分位数，第3四分位数）[M（Qt,Qu，）]表示，分别为3550元（1620元，6000元），2500元（1225元，4800元），2000元（1200元，4000元），2500元（1200元，4000元）。疼痛程度与年收入呈线性趋势（P〈0．05）。与慢性疼痛相关的因素主要有异常情绪、生活满意度、职业能力和年收入。4组伤员间SF-36量表的8个领域（生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能和精神健康）评分比较，差异均有统计学意义（P〈0．05），其中无疼痛组SF-36总分为（70．6±17．5）分，轻度疼痛组为（61．3±14．3）分，中度疼痛组（52．7±14．3）分，重度疼痛组为（52．3±14．7）分。疼痛程度与伤员生活质量呈负相关。结论五一二四川地震27个月后，大部分地震骨Objective To investigate factors related to chronic pain in those injured with fractures 27 months after the Sichuan earthquake. The correlation between intensity of pain and quality of life was also analyzed. Methods A total of 705 victims were investigated on site. Their residual pain was categorized using a visual analogue scale （VAS） score as no pain, mild pain, moderate pain or severe pain. The pain-related biological, psychological and social factors were analyzed using the Barthel Index （BI） , Life Satisfaction Questionaire-11 （LiSat-11 ） and the SF-36 health questionnaire. Rehabilitation and surgical interventions, employment, income and emotional status were also investigated. Results The incidence of chronic pain was 88.5% in this population, of which mild pain and moderate pain were 35.7% and 33.3% , respectively. The percentage of the victims who had received frac- ture surgery was 65.8% ; the percentage of those who had recovered was 96.9%. BI scores for the victims without pain, with mild, moderate and severe pain were 92.7 ± 10.2,92.8 ± 8.4,91.2 ± 9.9 and 90.4 ± 14.7, respectively ; the differences between these groups were all statistically insignificant. The influence of pain intensity on life sat- isfaction showed a significant linear trend. The percentages of the victims with restricted occupational ability in the four groups were 38.3% , 61.5% , 75.7% and 62.8% respectively. The median of personal annual income were ￥ 3550, ￥ 2500, g 2000 and￥ 2500. The VAS scores were significantly related to abnormal emotions, life satisfaction, employment and annual income. The subjects with different levels of residual pain also showed significant differences in the physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emo- tional and mental health sub-scales of the SF-36. The total SF-36 scores were highest among victims without pain （70.6± 17.5） and declined significantly in those with mild （61.3 ± 14.3 ）, moderate （52.7 ±

关 键 词：疼痛程度 简明健康调查量表 心理因素 社会因素 

分 类 号：R687.3[医药卫生—骨科学]