初次全髋关节置换术患者术后夜间疼痛相关因素分析

Influence factors of night pain after primary total hip arthroplasty

目的探究初次全髋关节置换术患者术后夜间疼痛的相关因素.方法选取2017年1-6月南京鼓楼医院骨科收治的初次全髋关节置换术患者115例,将出现夜间疼痛者74例作为疼痛组,未出现夜间疼痛者41例作为未疼痛组.收集2组患者基本特征及相关临床资料,用索尼SmartBand智能腕带进行睡眠监测,分析疼痛相关因素.结果单因素分析显示2组性别、体质量、受教育水平、婚姻状况、手术史、原发疾病、关节置换术类型、假体类型、情感因素、睡眠时间、习惯睡眠体位比较差异均无统计学意义(均P>0.05).疼痛组年龄>55岁者占比、平均年龄及合并糖尿病者占比均大于未疼痛组,差异均有统计学意义(均P<0.05).多因素Logistic回归分析结果显示,年龄>55岁(回归系数=0.867,标准误=0.627,比值比=2.235,Wald=4.125,P=0.026)以及合并糖尿病(回归系数=0.518,标准误=0.664,比值比=2.347,Wald=3.954,P=0.027)是影响全髋关节置换术患者术后夜间疼痛的重要因素.结论初次全髋关节置换术患者术后夜间疼痛与其年龄增长及患有糖尿病有相关性,因此,术后需尤其关注老年及合并糖尿病患者的恢复情况.

Objective To explore the influence factors of night pain in patients after primary total hip arthroplasty.Methods A total of 115 patients undergoing primary total hip arthroplasty from January 2017 to June2017 in Nanjing Drum Tower Hospital were enrolled;74 patients had night pain(night pain group)and 41 patients were included in non-pain group.Basic information and clinical records were collected.Sleep monitoring was performed with Sony Smart Band wristband.Factors affecting postoperative pain were analyzed.Results Univariate analysis showed no significant differences in sex,body mass,education level,marital status,operation history,primary diseases,types of joint replacement and prosthesis,emotion,length of sleep and sleep position between groups(all P>0.05).Rate of age>55 years,mean age and diabetes rate in night pain group were significantly higher than those in non-pain group(all P<0.05).Multivariate logistic analysis showed that age>55 years(coefficient of regression=0.867,standard deviation=0.627,odds ratio=2.235,Wald=4.125,P=0.026)and diabetes(coefficient of regression=0.518,standard deviation=0.664,odds ratio=2.347,Wald=3.954,P=0.027)were risk factors of night pain after total hip arthroplasty.Conclusions Postoperative night pain in patients undergoing primary total hip arthroplasty is associated with advanced age and diabetes.Special attention should be paid to the elderly and diabetic patients.