非小细胞肺癌患者肺叶切除术后慢性疼痛发生的影响因素

Analysis of Influencing Factors Affecting Chronic Pain after Lobbectomy in Patients with Non-small Cell Lung Cancer

目的探讨非小细胞肺癌(NSCLC)患者肺叶切除术后慢性疼痛(CPSP)发生的相关危险因素,为临床防治CPSP提供重要依据。方法回顾性分析行肺叶切除术的168例NSCLC患者临床资料。依据术后是否发生CPSP,分为CPSP组和非CPSP组,比较2组术前、术中及术后临床资料,分析NSCLC患者肺叶切除术后CPSP发生的相关危险因素。结果168例患者中CPSP发生率为47.62%(80/168),其中45例轻度疼痛,29例中度疼痛,6例重度疼痛。单因素分析显示,2组术前胸背部疼痛史、手术方式、住院时间、引流管放置时间及术后镇痛消耗吗啡当量相比,差异有统计学意义(P<0.05);多因素分析显示,术前有胸背部疼痛史、开胸手术、住院时间长、引流管放置时间长、术后镇痛消耗吗啡当量高是影响NSCLC患者肺叶切除术后CPSP发生的高危因素(P<0.05,且OR>1)。结论术前有胸背部疼痛史、开胸手术、住院时间长、引流管放置时间长、术后镇痛消耗吗啡当量高是NSCLC患者肺叶切除术后CPSP发生的重要危险因素,临床应重点关注,及时予以针对性干预措施,以减少CPSP发生。

Objective To explore the relevant risk factors of chronic pain(CPSP)after pulmonary lobbectomy in patients with non-small cell lung cancer(NSCLC),and to provide an important basis for the clinical prevention and treatment of CPSP.Methods The clinical data of 168 patients with NSCLC were retrospectively analyzed.According to whether postoperative CPSP,was divided into CPSP and non-CPSP groups,preoperative,intraoperative and postoperative clinical data were statistical analyzed,and risk factors related to CPSP after pulmonary lobbectomy in NSCLC patients were analyzed.Results The incidence of CPSP in 168 patients was 47.62%(80/168),Of these,45 cases had mild pain,In 29 cases of moderate pain,there had 6 cases of severe pain;Single-factor analysis showed that preoperative history of chest and back pain,surgical methods,hospitalization time,drainage tube placement time,and postoperative analgesic consumption of morphine equivalent between the 2 groups had significant difference(P 1).Conclusion Preoperative history of chest and back pain,thoracotomy surgery,long hospitalization time,long drainage tube placement time,and high postoperative morphine equivalent are important risk factors in NSCLC patients.We should focus on and give timely targeted intervention measures to reduce the occurrence of CPSP.