肛肠手术后慢性疼痛的危险因素分析  

Analysis of risk factors of chronic postsurgical pain after anorectal surgery

作　　者：袁建虎[1] 张旭光 杨茜芳 杨志军 陆海宁 李思杰 王晶[2] YUAN Jianhu;ZHANG Xuguang;YANG Qianfang;YANG Zhijun;LU Haining;LI Sijie;WANG Jing(Department of Anesthesiology,Beijing Rectum Hospital(Beijing Erlonglu Hospital),Beijing 100071,China)

机构地区：[1]北京市肛肠医院(北京市二龙路医院)麻醉科,100071 [2]首都医科大学附属北京朝阳医院麻醉科

出　　处：《临床麻醉学杂志》2023年第5期510-513,共4页Journal of Clinical Anesthesiology

基　　金：北京市肛肠医院(北京市二龙路医院)院内课题(cx20180001)。

摘　　要：目的探讨肛肠手术后慢性疼痛(CPSP)的危险因素。方法收集2018年8月至2019年10月择期行肛肠手术746例患者资料,并记录人口学特征、合并症、术前疼痛情况、围术期情况等。通过电话随访术后1、3个月时的疼痛情况,根据术后是否发生CPSP将患者分为两组:CPSP组和非CPSP组。采用多因素Logistic回归分析CPSP的危险因素。结果有37例(4.96%)患者发生CPSP。与非CPSP组比较,CPSP组术前合并疼痛、高血压、贫血、术后7 d VAS疼痛评分>3分、术后发生出血、睡眠障碍和便秘的比例明显升高(P<0.05)。多因素Logistic回归分析显示,术前疼痛(OR=3.022,P=0.013)、术前贫血(OR=2.235,P=0.017)、术后出血(OR=3.511,P=0.034)、术后睡眠障碍(OR=2.345,P=0.003)以及术后7 d VAS疼痛评分>3分(OR=4.323,P=0.006)是发生肛肠手术后CPSP的危险因素。结论肛肠手术CPSP发生率较低,术前疼痛、术前贫血、术后出血、术后睡眠障碍以及术后7 d VAS疼痛评分>3分是发生肛肠手术CPSP的危险因素。Objective To investigate the risk factors of chronic postsurgical pain(CPSP)after anorectal surgery.Methods The demographic characteristics,complications,preoperative pain,and perioperative information of 746 patients undergoing elective anorectal surgery from August 2018 to October 2019 were collected and analyzed.Patients were followed up 1 and 3 months after surgery by telephone.Patients were divide into two groups according to CPSP occurred:CPSP group and non-CPSP group.And multiple Logistic regression was used to analyze the risk factors of CPSP.Results Thirty-seven patients(4.96%)occurred CPSP.Compared with non-CPSP group,preoperative pain,hypertension,anemia,VAS pain score>3 points 7 days after surgery,postoperative bleeding,sleep disorders,and constipation were significantly increased in CPSP group(P<0.05).Multiple logistic regression analysis suggested that preoperative pain(OR=3.022,P=0.013),preoperative anemia(OR=2.235,P=0.017),postoperative bleeding(OR=3.511,P=0.034),postoperative sleep disorder(OR=2.345,P=0.003)and VAS pain scores>3 points 7 days after surgery(OR=4.323,P=0.006)were risk factors of CPSP after anorectal surgery.Conclusion The incidence of CPSP is low.Preoperative pain,preoperative anemia,postoperative bleeding,postoperative sleep disturbance and VAS pain scores>3 points 7 days after surgery will increase the occurrence of chronic pain after anorectal surgery.

关 键 词：肛肠手术 术后慢性疼痛 危险因素 

分 类 号：R614[医药卫生—麻醉学]