胸腔镜肺叶切除术患者发生慢性术后疼痛的危险因素分析

Risk Factors of Chronic Postsurgical Pain after Video-Assisted Thoracic Surgery

目的探讨胸腔镜肺叶切除术(video ssted thoracic surgery,VATS)患者发生慢性术后疼痛(chronie post surgical pain,CPSP)的危险因素。方法2019年3-6月,便利抽样法选择在四川大学华西医院胸外科择期行VATS的患者为研究对象。于术后1~3d.90d采用数字分级评分法(numerical rating scale,NRS)评估患者疼痛。根据术后90d NRS评分,将NRS评分为0分的患者归人无CPSP组;将NRS评分≥1分的患者归入CPSP组,探究影响CPSP的危险因素。结果最终纳人病例221例,CPSP发生率为65.2%。不同性别和术后急性疼痛程度的患者其在是否发生CPSP上的差异均有统计学意义(均P<0.05)。性别(OR=2.126,95%CI 1.166~3.900,P=0.014)、急性疼痛(OR=2.158.95%CI 1.158~4.039,P=0.016)是CPSP的影响因素。结论在胸腔镜肺叶切除术后护理中.医护人员要注意监测患者术后急性疼痛,尤其是女性患者,从而降低CPSP的发生率。

Objective To reduce the incidence of chronic post-surgical pain(CPSP),we investigated the risk factors for CPSP in patients with video assisted thoracic surgery(VATS).Methods Patients undergoing VATS were selected.Nu-merical rating scale(NRS)was used to evaluate the occurrence and intensity of CPSP on the 1-3 and 90 days after surgery.Patients were divided into the CPSP group and the non-CPSP group according to the presence of CPSP.Univariate analysis and multivariate logistic regression analysis were performed on the two groups.Results The incidence of CPSP was 65.2%in 221 cases included.Patents with different genders and degree of post surgical pain had statistically signifi-cant differences in the occurrence of CPSP(all P<0.05).Multivariate logistic regression results showed that gender(OR=2.126,95%CI 1.166-3.900,P=0.014),acute post-surgical pain(OR=2.158.95%CI1.158-4.039,P=0.016)were independent risk factors of CPSP.Conclusions Female and acute post surgical pain are independent risk factors for the development of CPSP in patients underwent VATS.