急性胰腺炎患者早期疼痛对疾病预后影响的研究

Study on the influence of early pain on the prognosis of acute pancreatitis

目的 调查急性胰腺炎(Acute Pancreatitis,AP)患者早期疼痛特征及现状,分析疼痛对疾病预后的影响.方法 选取2021年12月至2022年4月安徽某三甲医院急诊外科、急诊内科及消化内科收治住院的AP患者.收集患者的人口学资料、疼痛资料、血液学相关指标、预后指标.依据预后情况进行分组,校正年龄、既往史等因素后,采用二元logistic回归分析方法分析疼痛特征与疾病预后的关系.结果 本研究共纳入191例AP患者,有无并发症分别为39例、152例.单因素分析显示,两组间在人院后24h内重度疼痛持续时间、24~48h轻中度和重度疼痛时间、是否镇痛及48h内疼痛总时间及镇痛次数差异有统计学意义(P<0.05).住院天数<7天有75例,住院天数≥7天为116例,两组间在入院后24h内重度疼痛持续时间、24~48h轻中度和重度疼痛时间及48h内疼痛总时间差异有统计学意义(P<0.05).二元logistic回归分析结果显示,入院后24~48h重度疼痛持续时间及48h内疼痛持续总时间、禁食天数及BISAP评分是并发症发生的独立危险因素,而人院后24h内重度疼痛持续时间、人院后24~48h轻中度疼痛持续时间及血清白蛋白(ALB)数值是保护因素;住院期间疼痛累计总时间及禁食天数是住院时间的独立危险因素.结论 AP患者多为重度疼痛、持续时间长,并且疼痛是AP并发症发生及住院时间延长的独立危险因素,影响疾病的预后.

Objective To investigate the characteristics and status of early pain in patients with acute pancreatitis(AP),and to analyze the effect of pain on the prognosis of the disease.Methods From December 2021 to April 2022,AP patients who were hospitalized in emergency surgery,emergency internal medicine and gastroenterology department of a tertiary hospital in Anhui Province were selected.The demographic data,pain data,hematological-related indicators,and prognostic indicators of the patients were collected.The patients were divided into groups according to the prognosis.After adjusting for factors such as age and past history,binary logistic regression analysis was used to analyze the relationship between pain characteristics and disease prognosis.Results A total of 191 patients with AP were included in this study,With or without complication,39 cases and 152 cases respectively.Univariate analysis showed that there were statistically significant differences between the two groups in the duration of severe pain within 24 hours after admission,the time of mild to moderate pain from 24 to 48 hours,whether analgesia was performed,the total pain time and the number of analgesia within 48 hours(P<0.05).There were 75 patients with hospitalization days<7 days,and 116 patients with hospitalization days≥7 days.There were statistically significant differences between the two groups in the duration of severe pain within 24 hours,the time of mild to moderate pain from 24 to 48 hours,and the total pain time within 48 hours(P<0.05).The results of binary logistic regression analysis showed that the duration of severe pain within 24-48 hours after admission and the total duration of pain within 48 hours,fasting days and BISAP score were independent risk factors for complications,while the duration of severe pain within 24 hours after admission,Duration of severe pain within 24 hours after admission,duration of mild to moderate pain 24-48 hours after admission,and serum albumin(ALB)values are protective factors;the total cumulative pain time and the number of fasting days during hospitalization were independent risk factors for hospital stay.Conclusion Most of AP patients have severe pain with long duration,and pain is an independent risk factor for AP complications and prolonged hospital stay,which affects the prognosis of the disease.