经皮肾镜碎石取术后急性中重度疼痛的影响因素分析

The analysis of factors influencing acute moderate to severe pain after percutaneous nephrolithotomy

目的:探讨经皮肾镜碎石取石术(PCNL)的术后中重度疼痛发生率的影响因素。方法:回顾性分析2021年6月-2022年12月在我科行PCNL手术的患者资料,根据长海痛尺中重度疼痛诊断标准,将患者分为发生中重度疼痛组和未发生中重度疼痛组,先后进行单因素分析、多因素Logistic回归分析,确定PCNL术后急性中重度疼痛的独立影响因素。结果:研究期间共130例患者接受PCNL手术,根据纳排标准最终123例患者纳入本研究。术后急性中重度疼痛发生率为52.03%,其中重度疼痛达23.58%。中重度疼痛组和非中重度疼痛组在手术时间、通道型号、年龄、留置管道数目等方面有统计学差异(P<0.05)。多因素Logistic回归分析显示:年龄<50岁(OR=0.362,95%CI:0.155~0.845)、留置管道数目(OR=2.119,95%CI:1.086~4.133)是发生急性中重度疼痛的独立影响因素。结论:PCNL术后急性中重度疼痛发生率高,应引起医护人员重视,尤其是采用多通道手术时,应实施超前镇痛干预方案,提高患者康复质量。

Objective:To investigate the influencing factors of the incidence of moderate to severe postoperative pain following percutaneous nephrolithotomy(PCNL).Methods:The data of patients undergoing PCNL surgery in our department from June 2021 to December 2022 we the patients were divided into moderate and severe pain group and without moderate and severe pain group.Univariate analysis and multivariate logistic regression analysis were conducted successively.To determine the independent influencing factors of acute moderate to severe pain after PCNL.Results:During the study period,a total of 130 patients underwent PCNL surgery,and 123 patients were included in the study according to the criteria for inclusion and exclusion.The incidence of acute moderate to severe postoperative pain was 52.03%,of which severe pain was 23.58%.There were significant differences in operation time,channel type,age and number of channels between moderate to severe pain group and non-moderate to severe pain group(P<0.05).Multivariate logistic regression analysis showed that age<50 years old(OR=0.362,95%CI:0.155-0.845)and the number of channels(OR=2.119,95%CI:1.086-4.133)were independent factors for the occurrence of acute moderate to severe pain.Conclusion:The incidence of acute moderate to severe pain after PCNL surgery is high,which should be paid attention to healthcare providers,In particular,preemptive analgesic interventions should be implemented,especially in multi-tract surgeries,to improve patient recovery quality.