疼痛恐惧与肺癌胸腔镜术后疼痛的相关性研究

The relationship between preoperative fear of pain and postoperative pain in lung cancer patients with thoracoscopic surgery

目的探讨肺癌患者术前疼痛恐惧的水平与全麻胸腔镜术后疼痛程度的关系,以期为围手术期疼痛心理和行为的干预提供基础。方法选取华中科技大学同济医学院附属协和医院胸外科2018年8月至2019年12月行肺癌胸腔镜手术的患者100例,术前采用中文版疼痛恐惧问卷-Ⅲ收集患者的疼痛恐惧水平,术后收集患者静息时和咳嗽时的疼痛程度,采用相关性分析和相对危险系数评价患者术前疼痛恐惧和术后疼痛之间的关系。结果静息痛及咳嗽痛均与疼痛恐惧成正相关,相关系数分别为0.404和0.489(均P<0.05)。高疼痛恐惧水平的患者在咳嗽时更易报告重度疼痛,是非高疼痛恐惧水平患者的3.643倍(95%CI值为1.585~8.372)。结论术前的疼痛恐惧水平高的患者术后可能会报告更高的疼痛程度,且更易报告重度痛,对于该类患者需要进行筛查和识别,从而给予进一步的认知行为干预。

Objective To explore the relationship between the preoperative fear of pain(FOP)and postoperative pain in patients with lung cancer undergoing video-assisted thoracoscopic surgery,with a view to provide a basis for psychological and behavioral intervention in perioperative pain.Methods One hundred lung cancer patients underwent thoracoscopic surgery from August 2018 to December 2019 were recruited.The FOP was collected by the Chinese version of the fear of pain questionnaire-Ⅲbefore operation.And postoperative pain including rest pain and cough pain was collected after surgery.The correlation analysis and relative risk coefficient was used to evaluate the relationship between preoperative FOP and postoperative pain.Results Both rest pain and cough pain were positively correlated with FOP with the correlation coefficients of 0.404 and 0.489(both P<0.05).Patients with a high level of FOP before surgery were more likely to report severe pain when coughing after surgery,which was 3.643 times(95%CI value was 1.585-8.372)higher than the patients with non-high level preoperative FOP.Conclusions Patients with a high level preoperative FOP may report higher pain after surgery.Screening and identification of such patients are needed for further cognitive behavioral intervention.