前交叉韧带重建术后患者慢性疼痛的影响因素分析  

Analysis of influencing factors of chronic pain in patients after anterior cruciate ligament re⁃construction

作　　者：农钰红 刘桂瑛[1] 程建文[2] 王琦[2] 何晓红[2] 陈媚 NONG Yuhong;LIU GuiYing;CHENG Jianwen;WANG Qi;HE Xiaohong;CHEN Mei(Guangxi Medical University School of Nursing,Nanning 530021,China;The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Dongguan People’s Hospital,Dongguan 523058,China)

机构地区：[1]广西医科大学护理学院,南宁530021 [2]广西医科大学第一附属医院,南宁530021 [3]东莞市人民医院,东莞523058

出　　处：《广西医科大学学报》2024年第2期276-282,共7页Journal of Guangxi Medical University

基　　金：2020年广西研究生教育创新计划项目资助(No.JGY2020054);广西自然科学基金项目资助(No.2023GXNSFAA026430)。

摘　　要：目的:探讨前交叉韧带(ACL)重建术后慢性疼痛的影响因素。方法:回顾性分析在广西医科大学第一附属医院行ACL重建术的1109例患者的临床资料和术后3个月的随访资料,采用二元logistic回归模型分析慢性疼痛的影响因素。结果:ACL重建术患者术后3个月慢性疼痛患病发生率为21.46%(238/1109)。不同性别、年龄、婚姻状况、体质量指数、手术模式、术前膝关节滑膜炎、入院血栓风险评分、发生中重度疼痛次数(术后3 d)、关节腔积液情况、止血带使用时长、术后3个月膝关节活动情况及有无伤口引流管、有无慢性病、是否遵循康复锻炼计划、术后3个月患肢有无肿胀比较,差异均有统计学意义(均P<0.05)。logistic回归分析显示,40岁及以上年龄段、体质量指数≥24 kg/m2、住院手术、频繁的中重度疼痛、有伤口引流管、止血带使用时长≥100 min、未遵循康复锻炼计划和术后3个月膝关节肿胀是ACL重建术后慢性疼痛的独立危险因素(均P<0.05)。结论:频繁的中重度疼痛、术后有伤口引流管、止血带使用≥100 min、未遵循康复锻炼计划以及术后3个月膝关节肿胀等为ACL重建术后慢性疼痛的独立危险因素,慢性疼痛的发生率较高。Objective:To explore the influencing factors of chronic pain after anterior cruciate ligament(ACL)reconstruction.Methods:A retrospective analysis was conducted on the clinical data and 3-month postoperative follow-up data of 1,109 patients who underwent ACL reconstruction surgery in the First Affiliated Hospital of Guangxi Medical University.A binary logistic regression model was used to analyze the influencing factors of chronic pain.Results:The prevalence of chronic pain 3 months after ACL reconstruction surgery was 21.46%(238/1,109).Differences in gender,age,marital status,body mass index,surgical mode,preoperative knee synovitis,admission thrombosis risk score,number of moderate to severe pain episodes(within 3 days postoperatively),joint effusion,tourniquet use duration,knee joint mobility at 3 months postoperatively,presence or absence of wound drainage tube,presence or absence of chronic diseases,whether to adhere to rehabilitation exercise plan,and presence or absence of swelling of the operated limb at 3 months postoperatively were all statistically significant(all P<0.05).Logistic regression analysis revealed that age≥40 years,body mass index≥24 kg/m2,inpatient surgery,frequent moderate to severe pain,presence of wound drainage tube,tourniquet usage duration≥100 minutes,non-adherence to rehabilitation exercise plan,and knee joint swelling at 3 months postoperatively were independent risk factors for chronic pain after ACL reconstruction surgery(all P<0.05).Conclusion:Frequent moderate to severe pain,presence of wound drainage tube postoperatively,tourniquet usage≥100 minutes,non-adherence to rehabilitation exercise plan,and knee joint swelling at 3 months postoperatively are independent risk factors for chronic pain after ACL reconstruction surgery,with a higher incidence of chronic pain.

关 键 词：前交叉韧带重建术 慢性疼痛 影响因素 

分 类 号：R687.4[医药卫生—骨科学]