截肢术后幻肢痛发生的多因素回归分析

Multi-variate regression analysis of development of phantom limb pain after amputation

目的:探讨截肢患者幻肢痛发生的相关因素。方法:设计一份调查问卷,对226例行截肢手术的患者进行电话随访,应用单因素和多因素的分析方法,回顾性分析幻肢痛发生可能的相关因素。结果:单因素分析发现麻醉方式、术前疼痛、术后镇痛、并发症、残肢痛与幻肢痛发生相关(P<0.05),性别、年龄、职业、文化程度、婚姻状态、截肢原因、截肢部位、假肢安装与幻肢痛发生无关(P>0.05),多因素分析进一步证实影响幻肢痛发生的独立因素分别为术前疼痛(OR=2.60),残肢痛(OR=3.70),全身麻醉(OR=2.94)和术后镇痛(OR=0.44)(P<0.05)。结论:术前疼痛、残肢痛、全身麻醉是幻肢痛发生的相关危险因素,术后镇痛是幻肢痛发生的保护因素,对于预防幻肢痛的发生具有重要的作用。

Objective To investigate the factors related with the development of phantom limb pain （PLP） in amputated patients. Methods 226 cases of patient received amputation surgery have been surveyed using the method of telephone follow-up according to a designing questionnaire. The factors that may influence the development of PLP have been analyzed with univariately and multi-variately regression analysis. Results The factors which included method of anesthesia, pain before the amputation, postoperative analgesia, complication and stump pain were related with the development of PLP by univarite analysis （P 〈 0.05）. The factors which included sex, age, employment, level of education, marital status, reason of amputation, site of amputation and prosthesis have no relation with the development of PLP （P 〉 0.05）. The factors which included pain before the amputation （OR = 2.60）, stump pain （OR = 3.70）, general anesthesia （OR = 2.94） and postoperative analgesia （OR = 0.44） were independent factors in multi-variately analysis （P 〈 0.05）. Conclusions The factors which inculed pain before the amputation, stump pain and general anesthesia were found as the relevant risk factors for the development of PLP. Postoperative analgesia was the protective factor; it plays an important role in preventing the development of PLP.