食管癌患者术后疼痛情况调查及影响因素分析

Investigation and analysis of factors influencing postoperative pain in patients with esophageal cancer

目的了解食管癌患者术后的疼痛情况,分析影响患者术后疼痛程度的影响因素。方法选取食管癌患者229例,采用视觉模拟评分法(VAS)评估并比较不同临床资料患者间的术后疼痛程度,分析影响患者疼痛程度的相关因素。结果229例食管癌患者术后中度疼痛的发生率为25.8%,重度疼痛的发生率为12.7%;术后1月发生慢性疼痛者占29.7%。单因素分析发现:性别、年龄、BMI、手术方式、麻醉方式、肿瘤直径、吸烟与术后24 h中重度疼痛有关,BMI、手术方式、阿片类药物、肿瘤直径、吸烟、术后24 h中重度疼痛与食管癌患者发生慢性疼痛有关;差异均有统计学意义(P<0.05)。Logistic分析结果显示:女性、BMI≥24 kg/m^(2)、开放式手术、全麻、肿瘤直径≥3 cm、吸烟与食管癌患者术后24 h发生中重度疼痛独立相关(P<0.05),BMI≥24 kg/m^(2)、开放式手术、阿片类药物使用、肿瘤直径≥3 cm、吸烟、术后24 h中重度疼痛、营养评估≥3分与食管癌患者术后发生慢性疼痛独立相关(P<0.05)。结论食管癌术后部分患者易发生中重度急性疼痛和慢性疼痛;女性、BMI≥24 kg/m^(2)、开放式手术、全麻、肿瘤直径≥3 cm、吸烟与患者术后24 h发生中重度疼痛独立相关;BMI≥24 kg/m^(2)、开放式手术、阿片类药物使用、肿瘤直径≥3 cm、吸烟、术后24 h中重度疼痛、营养评估≥3分则与患者术后发生慢性疼痛独立相关。

Objective To investigate postoperative pain in patients with esophageal cancer and analyze the factors influencing its occurrence.Methods A total of 229 patients diagnosed with esophageal cancer was selected for the study.The visual analogue scale(VAS)was utilized to assess and compare postoperative pain levels among patients with varying clinical profiles,while also analyzing the factors that influence pain intensity.Results The prevalence of moderate pain was 25.8%,while the prevalence of severe pain was 12.7%among a cohort of 229 patients diagnosed with esophageal cancer.One month after surgery,chronic pain was reported by 29.7%of the patients.Univariate analysis revealed significant associations between gender,age,BMI,surgical approach,anesthesia method,tumor size,smoking status and the occurrence of moderate and severe postoperative pain within 24 hours.Furthermore,BMI,surgical approach,opioid use,tumor size,smoking status and the presence of moderate and severe postoperative pain were found to be significantly associated with chronic pain in esophageal cancer patients(P<0.05).Logistic analysis results indicate that in patients with esophageal cancer,the following factors were independently associated with moderate to severe pain 24 hours after surgery:being female,having a BMI≥24 kg/m^(2),undergoing open surgery under general anesthesia,having a tumor diameter≥3 cm,and smoking(P<0.05).Additionally,the following factors were independently associated with postoperative chronic pain:having a BMI≥24 kg/m^(2),undergoing open surgery,using opioids for pain management,having a tumor diameter≥3cm,smoking history,experiencing moderate to severe pain 24 hours after surgery and receiving a nutritional assessment score of≥3(P<0.05).Conclusions After surgery,certain patients with esophageal cancer exhibit a predisposition to experience both moderate and severe acute pain as well as chronic pain.Factors such as being female,having a BMI≥24 kg/m^(2),undergoing open surgery,general anesthesia,possessing a tumor diameter≥3 cm,and smoking have been identified as independent predictors of experiencing moderate to severe pain within 24 hours post-surgery.The presence of a BMI≥24 kg/m^(2),the requirement for open surgery,opioid usage,tumor diameter≥3 cm,smoking status,moderate to severe pain 24 hours post-surgery and nutritional assessment scores≥3 were found to be independently associated with the development of chronic postoperative pain.