腹膜透析导管植入术后早期疼痛的特点及影响因素分析  

Characteristics and risk factors of the pain after peritoneal dialysis catheter implantation

作　　者：昌瑶 林建雄[1] 易春燕[1] 陈晶晶 阳晓[1] 毛海萍[1] CHANG Yao;LIN Jian-xiong;YI Chun-yan;CHEN Jing-jing;YANG Xiao;MAO Hai-ping(Department of Nephrology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China)

机构地区：[1]中山大学附属第一医院肾内科

出　　处：《中国血液净化》2019年第10期681-684,共4页Chinese Journal of Blood Purification

基　　金：广州市科技计划(自体移植腹膜间皮细胞对腹膜纤维化的防治作用)(201704020167)

摘　　要：目的探讨腹膜透析导管植入术后疼痛的特点及影响因素。方法纳入2016年1~12月于中山大学附属第一医院行腹膜透析导管植入术的终末期肾病患者。用数字疼痛量表评估患者术后疼痛情况,分析相关影响因素。结果共纳入118例腹膜透析患者。90例(76.3%)患者术后发生中重度疼痛。中、重度疼痛组年龄较小(F=5.602,P=0.005)、疼痛持续时间较长(x^2=24.613,P<0.001)、术后活动引起的疼痛比例高(x^2=11.080,P=0.004);重度疼痛组术中大网膜活跃比例较高(x^2=5.943,P=0.024)。多因素分析显示,较小的年龄(OR=0.96,95%CI 0.93~0.99,P=0.011)、导管出口处疼痛(OR=3.08,95%CI1.14~8.36,P=0.027)、术后活动引起疼痛(OR=3.04,95%CI1.12~8.24,P=0.029)是患者术后发生中重度疼痛的独立危险因素。结论腹膜透析导管植入术后中重度疼痛发生率为76.3%。分析患者疼痛的特点及影响因素,有助于制定相应的措施,缓解疼痛。Objective The aim of this study was to explore the characteristics and risk factors of the pain after peritoneal dialysis(PD) catheter implantation. Methods The end-stage renal disease patients undergoing PD catheter implantation in our hospital from January to December 2016 were recruited in this study. Numerical Rating Scale(NRS) was used to evaluate the pain. Patients were divided into three groups according to their pain score: mild, moderate and severe pain groups. Their demographic and clinical data were also collected. Results A total of 118 patients who received peritoneal dialysis catheter insertion in our center were enrolled in this study. Ninety(76.3%) patients had moderate to severe pain. Compared with mild pain group, patients in moderate and severe pain groups had younger age(F=5.602, P=0.005), longer time of postoperative pain(χ^2=24.613, P<0.001), and higher proportion of pain caused by postoperative activity(χ^2=11.080, P=0.004). A higher proportion of the patients in severe pain group had active omentum during operation(χ^2=5.943, P=0.024). Multivariate logistic analysis showed that younger age(OR=0.96, 95% CI 0.93~0.99, P=0.011), catheter exit-site pain(OR=3.08, 95% CI 1.14~8.36, P=0.027) and pain caused by postoperative activity(OR=3.04, 95% CI 1.12~8.24, P=0.029) were the independent risk factors for postoperative moderate to severe pain. Conclusions The incidence of moderate to severe pain was 76.3% in patients after PD catheter insertion. The analysis of the characteristics and risk factors of the pain is useful for the search of appropriate measures to relieve the pain.

关 键 词：腹膜透析 导管植入 疼痛 

分 类 号：R459.5[医药卫生—治疗学]