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股骨颈骨折患者全髋关节置换术后爆发痛发生的影响因素

Influencing factors of breakthrough pain after total hip replacement for femoral neck fractures
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摘要 目的探讨股骨颈骨折患者全髋关节置换术后爆发痛发生的影响因素。方法前瞻性研究。抽取2020年10月至2021年12月郑州大学附属郑州中心医院收治的120例股骨颈骨折患者,均行全髋关节置换术治疗,于术后24 h采用视觉模拟评分法(VAS)评估患者疼痛程度,统计术后爆发痛发生情况,将发生爆发痛者纳入发生组,未发生爆发痛者纳入未发生组。设计临床资料调查表,纳入所有可能影响股骨颈骨折患者全髋关节置换术后爆发痛发生的因素,详细调查120例股骨颈骨折患者的临床资料并进行统计。采用Logistic回归分析全髋关节置换术后爆发痛发生的影响因素。结果120例患者全髋关节置换术后24 h时VAS评分为(4.80±2.28)分,出现爆发痛者68例(56.67%),纳入发生组;未出现爆发痛者52例(43.44%),纳入未发生组。两组患者性别、Garden分型、体质指数、骨折至手术时间、手术用时、术后住院时间、婚姻状况、既往骨折史、假体类型、合并高血压、合并糖尿病比较,差异未见统计学意义(P>0.05);两组年龄、术前VAS评分、术前骨密度比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄≥60岁、术前VAS评分高是股骨颈骨折患者全髋关节置换术后爆发痛发生的危险因素(OR>1,P<0.05),术前骨密度高是其保护因素(OR<1,P<0.05)。结论年龄、术前VAS评分、术前骨密度是股骨颈骨折患者全髋关节置换术后爆发痛发生的影响因素,临床可对此进行针对性干预。 Objective To investigate the influencing factors of breakthrough pain after total hip replacement for femoral neck fractures.Methods This was a prospective study.A total of 120 patients with femoral neck fractures who were treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from October 2020 to December 2021 were selected.All patients underwent total hip replacement.At 24 hours after surgery,the patient’s pain level was evaluated using visual analogue scale(VAS),and the occurrence of postoperative breakthrough pain was recorded.Those who experienced breakthrough pain were included in the occurrence group,while those who did not experience breakthrough pain were included in the non occurrence group.The clinical data questionnaire was designed,and all the factors that may affect the occurrence of breakthrough pain after total hip replacement in patients with femoral neck fractures were included.The clinical data of 120 patients with femoral neck fractures were thoroughly investigated and statistically analyzed.The influencing factors of postoperative breakthrough pain were analyzed by logistic regression analysis.Results The VAS score of the 120 patients 24 hours after total hip replacement was 4.80±2.28;while 68 patients(56.67%)had breakthrough pain,and they were included in the occurrence group;52 cases(43.44%)did not experience breakthrough pain,and they were included in the non occurrence group.There was no statistical significant difference between the two groups in gender,Garden classification,body mass index,time from fracture to operation,time of operation,length of hospital stay after operation,marital status,previous fracture history,prosthesis type,hypertension and diabetes(P>0.05).There were statistical significant differences in age,preoperative VAS score and preoperative bone mineral density between the two groups(P<0.05).Results of logistic regression analysis showed that age≥60 years and high preoperative VAS score were the risk factors for the occurrence of breakthrough pain after total hip replacement in patients with femoral neck fractures(OR>1,P<0.05),and high preoperative bone mineral density was the protective factor(OR<1,P<0.05).Conclusions Age,preoperative VAS score and preoperative bone mineral density are the influencing factors for the occurrence of breakthrough pain after total hip replacement for femoral neck fractures,which can be targeted for clinical intervention.
作者 郭申杰 张亚琴 崔鑫鑫 Guo Shenjie;Zhang Yaqin;Cui Xinxin(Department of Orthopedics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)
出处 《中国实用医刊》 2023年第14期25-28,共4页 Chinese Journal of Practical Medicine
关键词 股骨颈骨折 全髋关节置换术 术后爆发痛 影响因素 Femoral neck fractures Total hip replacement Postoperative breakthrough pain Influencing factor
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