乳腺癌患者外科治疗后疼痛的影响因素研究

The factors influencing postoperative pain in breast cancer patients

目的调查乳腺癌患者外科治疗后急性疼痛的流行病学特征,探究乳腺癌治疗后急性疼痛的相关因素。方法选取在本院接受治疗的120例乳腺癌患者,依据是否出现治疗后急性疼痛分为两组,乳腺切除术后疼痛(PMPS)组和非PMPS组,分别于治疗前及治疗后记录患者的个体特征及治疗情况,对相关因素进行分析。结果两组患者在年龄、病程、分期、术前焦虑抑郁、肋间臂神经切除、腋淋巴结清扫、辅助化疗、术后出血或积液、合并其他疼痛综合征等方面的差异有统计学意义(P﹤0.05),其中年龄、术后出血或积液、腋淋巴结清扫、治疗前焦虑是乳腺癌治疗后急性疼痛的独立相关因素(P﹤0.05)。结论低龄乳腺癌患者更易出现治疗后急性疼痛。合理选择外科治疗范围和方式并对患者心理进行干预有助于缓解疼痛。

Objective To investigate the epidemiological characteristics of acute pain after surgical treatment of breast cancer, and explore the related factors. Method 120 cases of breast cancer patients were included in the study, and were stratified as post mastectomy pain syndrome （PMPS） group or non-PMPS group according to the respective status of postoperative acute pain, then the baseline and postoperative characteristics and treatment outcomes of the two groups were observed and compared, and related factors were analyzed. Result Age, disease course, staging, preoperative anxi-ety or depression, intercostobrachial nerve resection, axillary lymph node dissection, adjuvant chemotherapy, postopera-tive bleeding or effusion, and other combined pain syndromes were significantly different between PMPS and non-PMPS group （P〈0.05）, in which age, postoperative bleeding and effusion, axillary lymph node dissection and preoperative anxi-ety or depression were independent factors associated with acute pain after breast cancer treatment. Conclusion Younger breast cancer patients are more likely to develop acute pain after treatment. Rational selection of surgical treatment meth-od and effective psychological interventions are helpful in relieving patients’pain.