影响创伤骨科患者术后疼痛的相关因素研究

Research on the related factors in patients with postoperative pain of orthopedic trauma

目的探讨创伤骨科患者术后疼痛的影响因素。方法回顾性分析2011年9月—2015年9月武汉市东西湖区人民医院收治的224例创伤骨科患者行外科手术治疗的临床资料,根据患者术后主诉情况分为疼痛组(n=89)与非疼痛组(n=135)。采用多元Logistic回归模式对创伤骨科患者术后疼痛的相关影响因素进行观察、分析。结果疼痛组患者平均年龄较低、女性、性格外向、高学历、心理状态不佳、体位不当,治疗过程中牵引、外固定等,医护人员对疼痛评估知识缺乏比例均显著高于非疼痛组(P<0.05),但两组患者骨折部位及骨折原因方面的差异均无统计学意义(P>0.05);经多元Logistic回归模型分析,最终得出影响创伤骨科患者术后疼痛相关因素包括:年龄、性别、性格、文化程度、心理状态、体位、治疗中的因素以及医护人员自身因素(P<0.05)。结论影响创伤骨科患者术后疼痛相关因素较多,应注意对这些因素的密切观察,并采取相关处理措施,以改善患预后状况。

Objective To explore the influence factors of postoperative pain for traumatic orthopedic patients. Methods The clinical data of 224 patients with orthopedic trauma from Sep. 2011 to Sep. 2015 who accepted the routine surgical treatment was retrospectively analyzed. According to the conditions which the patients complained,the patients were divided into the pain group（ n = 89） and non-pain group（ n = 135）. Multivariate logistic regression was applied to observe and analyze the influential factors of related pain after orthopedic trauma.Results The proportions of low mean age,female,extroverted,highly educated,poor mentality,improper position,traction during the course of treatment,external fixation,lack of knowledge of the medical staff to assess pain in the pain group were significantly higher than those of non-pain group（ P〈0. 05）,but the differences of causes of fracture and fracture site between the two groups of patients showed no significant difference（ P〈0. 05）. By multivariate logistic regression analysis,the results showed that influence factors of postoperative pain after orthopedic trauma included age,gender,personality,education,mental status,position,treatment factors and factors of their medical staff（ P〈0. 05）. Conclusion Postoperative pain after orthopedic trauma are related to many factors,attention should be closely paid on these factors,and relevant action should be taken to improve the prognosis for patients.