慢性手术后疼痛的类型及伴随症状分析

THE CLINICAL CHARACTERISTICS OF PAIN ASSOCIATED SYMPTOMS OF PATIENTS WITH CHRONIC POST-SURGICAL PAIN

目的：慢性手术后疼痛患者临床上并非罕见,主要是人们缺乏认识和经验,本文通过临床调查、分析疼痛的性质、特征和伴随症状,以期引起临床外科医师的关注和重视。方法：通过收集门诊和住院共计70例慢性手术后疼痛患者统计资料。分别记录疼痛种类、程度、性质、住院次数、手术次数、心理和行为变化、失望和无助感、工作质量、生活质量、睡眠状态、体能状态等指标进行分析。结果：70例慢性手术后疼痛患者的平均病程为18个月;疼痛性质以紧束样疼痛为主（50/70,71.44%）;其次为烧灼样疼痛（11/70,15.71%）,闪电样疼痛（5/70,7.14%）牵拉样疼痛（4/70,5.71%）;平均住院次数为3.5次,平均就诊科室为5.8个,平均VAS评分为4.6分～7.8,大多数患者有不同程度的求医失望或无助感（65/70,92.8%）、睡眠障碍（64/70,91.4%）、体能和生活质量降低（53/70,75.71%）。结论：本组慢性手术后疼痛患者疼痛性质以紧束样疼痛为主,盆腔手术以烧灼疼痛为主,大多数患者有不止一次的住院经历和不同程度的心理异常、睡眠障碍、无助感或求医无门的感觉。临床医师应该逐步关注慢性手术后疼痛患者。

Objective： Chronic post-surgical pain （CPSP） is an under-recognized disease in clinic and is needed to pay much attention by surgeon. Methods： There are 70 cases with CPSP in this group and the index of prevalence, characteristics and intensities of pain, associated psychological symptoms and times of in-hospital, helpless feeling or disappointed in doctor, sleeping disorder and body energy are investigated in clinic. Results： The average duration of pain in 70 cases is 18 months, the most symptom is tightening （71.44%）, second is burning （ 15.71% ）, then lightening （7. 14% ） and pulling （5.71%）. Very higher percent of helpless feeling or disappointed in doctor（65/70,92.8% ） and sleeping disorder （64/70,91.4%） can be observed in the group. The average VAS score is 4.6 - 7.8 and times of in hospital is 3.5. Conclusion ： Most of the patients with CPSP, suffering from tightening pain and sleeping disorder, disappointed in doctor or helpless and psychological symptoms as well, are not be relieved. It is necessary that much more attentions should be paid to patients with CPSP in clinical practice.