术前疼痛灾难化认知状态对混合痔术后疼痛的影响

The Impact of Preoperative Pain Catastrophizing Cognitive State on Postoperative Pain in mixed hemorrhoids

目的:探讨术前疼痛灾难化认知状态对混合痔患者术后疼痛的影响。方法:选取2021年11月~2022年11月于保定市第一中医院行混合痔手术的80例患者为研究对象,术前采用疼痛灾难化量表(Pain Catastrophizing Scale,PCS)进行疼痛灾难化认知状态评估,按照评估结果分为观察组23例(疼痛灾难化认知状态,PCS评分≥38分)和对照组57例(无疼痛灾难化认知状态,PCS评分<38分),比较两组术后6h的疼痛视觉模拟量表(Visual Analog Scale,VAS)、状态焦虑问卷(State Anxiety Inventor,S-AI)、心率、平均动脉压等指标变化。结果术后6h VAS评分观察组高于对照组,差异具有统计学意义(P<0.05),S-AI评分观察组评分高于对照组,差异具有统计学意义(P<0.05),术后6h心率观察组高于对照组,差异具有统计学意义(P<0.05),术后6h平均动脉压差异无统计学意义(P>0.05)。结论:术前疼痛灾难化认知状态可预测混合痔术后患者疼痛及焦虑程度,增加患者术后心率,术前评定疼痛灾难化认知状态有利于预见性优化个体化镇痛方案。

Objective This study aims to investigate the impact of preoperative pain catastrophizing cognitive state on postoperative pain in patients with mixed hemorrhoids.Methods A total of 80 patients with mixed hemorrhoids who underwent surgery at Baoding NO.1 Hospital of Traditional Chinese Medicine from November 2021 to November 2022 were included as research subjects.The Pain Catastrophizing Scale(PCS)was used to assess the catastrophizing cognitive state prior to surgery,and based on the evaluation results,patients were divided into two groups:an observation group(23 cases)with a PCS score≥38 points indicating a catastrophizing cognitive state,and a control group(57 cases)with a PCS score<38 points indicating a non-catastrophizing cognitive state.Changes in visual analog scale(VAS),State Anxiety Inventory(S-AI),heart rate,mean arterial pressure,and other indicators were compared between the two groups at 6 hours after surgery.Results At 6 hours after surgery,the VAS scores in the observation group were significantly higher than those in the control group(P<0.05).Additionally,there was a statistically significant difference in S-AI scores between the observation and control groups(P<0.05).The heart rate of the observation group at 6h after surgery was higher than that of the control group,the difference was statistically significant(P<0.05),but the mean arterial pressure at 6h after surgery was not statistically significant(P>0.05).Conclusion The pain catastrophizing cognitive status before surgery can predict the degree of pain and anxiety and increase the heart rate of patients after mixed hemorrhoid surgery.The evaluation of pain catastrophizing cognitive status before surgery is conducive to the predictive optimization of individual analgesia.