早期非小细胞肺癌患者胸腔镜肺叶切除术后慢性疼痛的风险因素及其预防策略研究

Risk factors and prevention strategies for chronic pain after thoracoscopic lobectomy in patients with early non-small cell lung cancer

目的探讨早期非小细胞肺癌(NSCLC)患者胸腔镜肺叶切除术后发生慢性疼痛的风险因素及其预防策略。方法回顾性分析赤峰学院附属医院2019年1月至2023年5月收治的接受胸腔镜肺叶切除术的150例早期NSCLC患者的临床资料,根据术后慢性疼痛发生情况分为发生组(41例)和未发生组(109例)。采用Logistic回归分析探讨早期NSCLC患者胸腔镜肺叶切除术后慢性疼痛的影响因素。结果发生组与未发生组在有无焦虑、是否合并糖尿病、术前有无前胸背部疼痛史、术后镇痛消耗吗啡当量、引流管放置时间及住院时间方面比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有焦虑、合并糖尿病、术前有胸背部疼痛史、术后镇痛消耗吗啡当量多、引流管放置时间长及住院时间长是影响早期NSCLC患者胸腔镜肺叶切除术后发生慢性疼痛的独立危险因素(P<0.05)。结论早期NSCLC患者胸腔镜肺叶切除术后慢性疼痛与有焦虑、合并糖尿病、术前有胸背部疼痛史、术后镇痛消耗吗啡当量多、引流管放置时间长及住院时间长等密切相关,临床可据此给予患者针对性预防策略,以降低患者术后慢性疼痛发生的风险。

Objective To investigate the risk factors and prevention strategies for chronic pain after thoracoscopic lobectomy in patients with early non-small cell lung cancer(NSCLC).Methods The clinical data of 150 early-stage NSCLC patients who treated with thoracoscopic lobectomy in the Affiliated Hospital of Chifeng University from January 2019 to May 2023 was analyzed retrospectively.According to the incidence of postoperative chronic pain,they were divided into occurring group(41 cases)and non-occurring group(109 cases)respectively.The influencing factors of chronic pain after thoracoscopic lobectomy in early NSCLC patients were investigated using Logistic regression analysis.Results There were significant differences between the occurrence group and the non-occurrence group in terms of whether there was anxiety,whether there was diabetes,whether there was preoperative chest and back pain,morphine equivalent consumption for postoperative analgesia,drainage tube placement time and hospital stay(P<0.05).Multivariate Logistic regression analysis showed that anxiety,diabetes,preoperative chest and back pain,more morphine equivalent for postoperative analgesia,long drainage tube placement time,and long hospital stay were independent risk factors for chronic pain after thoracoscopic lobectomy in patients with early NSCLC(P<0.05).Conclusion Chronic pain after thoracoscopic lobectomy for early NSCLC were closely related to anxiety,diabetes,preoperative chest and back pain,more morphine equivalent for postoperative analgesia,long drainage tube placement time,and long hospital stay.Clinically,targeted prevention strategies can be given to patients to reduce the risk of postoperative chronic pain.