摘要
目的:探讨前交叉韧带(ACL)重建术后慢性疼痛的影响因素.方法:回顾性分析在广西医科大学第一附属医院行ACL重建术的1 109例患者的临床资料和术后3个月的随访资料,采用二元logistic回归模型分析慢性疼痛的影响因素.结果:ACL重建术患者术后3个月慢性疼痛患病发生率为21.46%(238/1 109).不同性别、年龄、婚姻状况、体质量指数、手术模式、术前膝关节滑膜炎、入院血栓风险评分、发生中重度疼痛次数(术后3d)、关节腔积液情况、止血带使用时长、术后3个月膝关节活动情况及有无伤口引流管、有无慢性病、是否遵循康复锻炼计划、术后3个月患肢有无肿胀比较,差异均有统计学意义(均P＜0.05).logistic回归分析显示,40岁及以上年龄段、体质量指数≥24 kg/m2、住院手术、频繁的中重度疼痛、有伤口引流管、止血带使用时长≥100 min、未遵循康复锻炼计划和术后3个月膝关节肿胀是ACL重建术后慢性疼痛的独立危险因素(均P＜0.05).结论:频繁的中重度疼痛、术后有伤口引流管、止血带使用≥100 min、未遵循康复锻炼计划以及术后3个月膝关节肿胀等为ACL重建术后慢性疼痛的独立危险因素,慢性疼痛的发生率较高.
Abstract
Objective:To explore the influencing factors of chronic pain after anterior cruciate ligament(ACL)reconstruction.Methods:A retrospective analysis was conducted on the clinical data and 3-month postoperative follow-up data of 1,109 patients who underwent ACL reconstruction surgery in the First Affiliated Hospital of Guangxi Medical University.A binary logistic regression model was used to analyze the influencing factors of chronic pain.Results:The prevalence of chronic pain 3 months after ACL reconstruction surgery was 21.46%(238/1,109).Differences in gender,age,marital status,body mass index,surgical mode,preoperative knee synovi-tis,admission thrombosis risk score,number of moderate to severe pain episodes(within 3 days postoperatively),joint effusion,tourniquet use duration,knee joint mobility at 3 months postoperatively,presence or absence of wound drainage tube,presence or absence of chronic diseases,whether to adhere to rehabilitation exercise plan,and presence or absence of swelling of the operated limb at 3 months postoperatively were all statistically signifi-cant(all P＜0.05).Logistic regression analysis revealed that age≥40 years,body mass index≥24 kg/m2,inpatient surgery,frequent moderate to severe pain,presence of wound drainage tube,tourniquet usage duration≥100 min-utes,non-adherence to rehabilitation exercise plan,and knee joint swelling at 3 months postoperatively were inde-pendent risk factors for chronic pain after ACL reconstruction surgery(all P＜0.05).Conclusion:Frequent mod-erate to severe pain,presence of wound drainage tube postoperatively,tourniquet usage≥100 minutes,non-adher-ence to rehabilitation exercise plan,and knee joint swelling at 3 months postoperatively are independent risk fac-tors for chronic pain after ACL reconstruction surgery,with a higher incidence of chronic pain.
基金项目
广西研究生教育创新计划(2020)(JGY2020054)
广西自然科学基金(2023GXNSFAA026430)
维普
万方数据