胸腔镜肺叶切除术患者发生慢性术后疼痛的危险因素分析  

Risk Factors of Chronic Postsurgical Pain after Video-Assisted Thoracic Surgery

作　　者：胡建容 闫伟东 贾晨阳 吕沛林[2] HU Jianrong;YAN Weidong;JIA Chenyang;LV Peilin(Department of Operation Room,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Anesthesiology,West China Hospital of Sichuan University;Department of Epidemiology,College of Public Health of Harbin Medical University,Harbin 150086,Heilongjiang Province,China)

机构地区：[1]四川大学华西医院手术室,四川成都610041 [2]四川大学华西医院麻醉科 [3]哈尔滨医科大学公共卫生学院流行病学教研室,黑龙江哈尔滨150081

出　　处：《解放军护理杂志》2021年第2期45-47,共3页Nursing Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金资助项目(81801117)。

摘　　要：目的探讨胸腔镜肺叶切除术(video ssted thoracic surgery,VATS)患者发生慢性术后疼痛(chronie post surgical pain,CPSP)的危险因素。方法2019年3-6月,便利抽样法选择在四川大学华西医院胸外科择期行VATS的患者为研究对象。于术后1~3d.90d采用数字分级评分法(numerical rating scale,NRS)评估患者疼痛。根据术后90d NRS评分,将NRS评分为0分的患者归人无CPSP组;将NRS评分≥1分的患者归入CPSP组,探究影响CPSP的危险因素。结果最终纳人病例221例,CPSP发生率为65.2%。不同性别和术后急性疼痛程度的患者其在是否发生CPSP上的差异均有统计学意义(均P<0.05)。性别(OR=2.126,95%CI 1.166~3.900,P=0.014)、急性疼痛(OR=2.158.95%CI 1.158~4.039,P=0.016)是CPSP的影响因素。结论在胸腔镜肺叶切除术后护理中.医护人员要注意监测患者术后急性疼痛,尤其是女性患者,从而降低CPSP的发生率。Objective To reduce the incidence of chronic post-surgical pain(CPSP),we investigated the risk factors for CPSP in patients with video assisted thoracic surgery(VATS).Methods Patients undergoing VATS were selected.Nu-merical rating scale(NRS)was used to evaluate the occurrence and intensity of CPSP on the 1-3 and 90 days after surgery.Patients were divided into the CPSP group and the non-CPSP group according to the presence of CPSP.Univariate analysis and multivariate logistic regression analysis were performed on the two groups.Results The incidence of CPSP was 65.2%in 221 cases included.Patents with different genders and degree of post surgical pain had statistically signifi-cant differences in the occurrence of CPSP(all P<0.05).Multivariate logistic regression results showed that gender(OR=2.126,95%CI 1.166-3.900,P=0.014),acute post-surgical pain(OR=2.158.95%CI1.158-4.039,P=0.016)were independent risk factors of CPSP.Conclusions Female and acute post surgical pain are independent risk factors for the development of CPSP in patients underwent VATS.

关 键 词：慢性术后疼痛 胸腔镜肺叶切除术 危险因素 

分 类 号：R473.6[医药卫生—护理学]