胸腔镜辅助开胸手术患者术后慢性疼痛的影响因素分析

Analysis of ralated factors of chronic post surgical pain of videoassisted thoracic surgery

目的 了解胸腔镜辅助开胸手术（VATS）患者术后慢性疼痛（CPSP）的发生率并探讨其影响因素.方法 采取便利抽样法抽取2016年1—6月某三级甲等综合医院胸外科行择期行VATS患者216例,术后第1~3天采用VAS评定疼痛程度,术后1~3个月时进行简易McGill疼痛问卷（SF-MPQ）调查,分析CPSP的特点,并对11项相关危险因素进行统计学分析.结果 完成随访的199例患者中,术后3个月时CPSP的发生率是49.20%,其中18.37%为中重度疼痛,32.65%为持续性疼痛;年龄（OR=2.16）和术后1~3 d疼痛程度（OR=2.25）是术后慢性疼痛的独立危险因素（P〈0.05）.结论 CPSP在VATS术后患者中占有一定的比例.积极有效控制术后急性期疼痛尤其是年轻患者的术后疼痛,可能有助于减少CPSP的发生.

Objective To explore the incidence of chronic postsurgical pain （CPSP） of video assisted thoracic surgery（VATS） and its influencing factors.Methods Totally 216 patients who received elective VATS in a class Ⅲ grade A hospital between January and June 2016 were selected by convenience sampling. Their pain level was assessed with Visual Analogue Scale （VAS） in 1 to 3 days after surgery. The patients were then investigated with Simplified McGill Pain Questionnaire （SF-MPQ） in 1 to 3 months after surgery,with the features of CPSP analyzed and 11 related risk factors statistically analyzed.Results The incidence of CPSP in 3 months after surgery in the 199 patients who received follow-up visits was 49.20%,of which 18.37% suffered moderate pain,and 32.65% felt constant pain. Age （OR=2.16） and pain level in 1-3 days after surgery （OR=2.25） were independent risk factors to CPSP （P〈0.05）.Conclusions CPSP occurred in a certain proportion of patients who received VATS. Actively and effectively controlling acute post surgical pain in especially young patients may help to reduce the incidenc of CPSP.