术后急性疼痛对子宫恶性肿瘤患者康复质量的影响  

Effect of acute post-surgical pain on the rehabilitation quality of patients with uterine malignant tumors

作　　者：黄桂菊 吕晓红 贾旭琴[1] 谢玉波[1] Huang Guiju;Lyu Xiaohong;Jia Xuqin;Xie Yubo(Department of Anesthesiology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院麻醉科,南宁530021 [2]山西医科大学附属肿瘤医院麻醉科

出　　处：《北京医学》2025年第2期116-120,共5页Beijing Medical Journal

基　　金：广西科技计划项目(桂科AB24010066);广西医科大学第一附属医院2022年度医院创新团队项目(YYZS2022001)。

摘　　要：目的探讨术后急性疼痛(acute post-surgical pain,APSP)对子宫恶性肿瘤患者康复质量的影响。方法选取2019年5月至2020年12月广西医科大学第一附属医院择期行子宫恶性肿瘤手术的患者90例。根据术后72 h内数字评价量表(number rating scale,NRS)评分的最大值将患者分为APSP组(NRS>3分)和非APSP组(NRS≤3分)。记录术前1 d的疼痛灾难化量表(pain catastrophizing scale,PCS)评分、焦虑自评量表(self-rating anxiety scale,SAS)评分,记录术前1 d,术后第1、3、7、14及30 d的欧洲五维健康量表(EuroQol-5 dimension,EQ-5D)评分,比较两组患者在不同时点的EQ-5D评分及术后康复质量。结果90例患者年龄28~68岁,平均(51.6±8.6)岁,40例患者出现APSP,发生率为44.4%。与非APSP组比较,APSP组患者术后1、3、7、14、30 d EQ-VAS评分更低,术后1、3、7 d活动能力和自我护理维度评分更高,术后1、3、7、14、30 d日常活动维度评分更高,术后1、3、7、14 d疼痛或不适维度评分更高,术后1、3 d焦虑或抑郁维度评分更高,差异均有统计学意义(P<0.05)。结论APSP会降低子宫恶性肿瘤患者康复质量,建议使用多模式镇痛方案,同时关注患者的术后活动水平、不适感以及焦虑或抑郁等心理健康问题的发生情况。Objective To explore the effect of acute post-surgical pain(APSP)on the rehabilitation quality of patients with uterine malignant tumors.Methods A total of 90 patients with uterine malignant tumors underwent elective surgery in the First Affiliated Hospital of Guangxi Medical University from May 2019 to December 2020 were selected,and were divided into the APSP group(NRS>3)and the non-APSP group(NRS≤3)according to the maximum of the number rating scale(NRS)scores in the 72 h after surgery.The pain catastrophizing scale(PCS)score and self-rating anxiety scale(SAS)score were recorded 1 d before surgery.The EuroQol-5 dimension(EQ-5D)scores were recorded 1 d before surgery and at 1,3,7,14 and 30 d after surgery.The EQ-5D scores at different time points and the quality of postoperative recovery between the two groups were compared.Results All 90 patients aged from 28 to 68 years,with an average of(51.6±8.6)years,and 40 patients presented with APSP,with an incidence rate of 44.4%.Compared with the non-APSP group,patients in the APSP group had lower EQ-VAS scores at 1,3,7,14,and 30 d postoperatively,higher scores on the mobility and selfcare dimensions at 1,3,and 7 d postoperatively,higher scores on the activities of daily living dimensions at 1,3,7,14,and 30 d postoperatively,higher scores on the pain or discomfort dimensions at 1,3,7,and 14 d postoperatively,and higher scores on the anxiety or depression dimensions at 1 and 3 d postoperatively,and the differences were statistically significant(P<0.05).Conclusions APSP reduces the rehabilitation quality of patients with uterine malignant tumors,so it is suggested to use multi-mode analgesia scheme,and at the same time pay attention to the postoperative activity level,discomfort and the occurrence of mental health problems such as anxiety or depression.

关 键 词：子宫恶性肿瘤 术后急性疼痛 康复质量 

分 类 号：R737.33[医药卫生—肿瘤]