摘要
目的 分析研究腔镜胆囊切除术后慢性疼痛的危险因素.方法 选取江西省萍乡市赣西医院外一科2019年1月1日至2024年1月1日期间收治的102例腹腔镜胆囊切除术患者为调查研究对象,患者均完成腹腔镜胆囊切除术,对患者术后2个月进行门诊随访观察,以视觉模拟评分(VAS)量表评估患者的疼痛程度,根据得分情况统计患者术后慢性疼痛发生率,并将患者分为慢性疼痛组和无痛组.采用问卷调查的方式对患者的一般资料和临床资料进行问卷调查收集,以单因素和多因素logistic回归分析腹腔镜胆囊切除术后慢性疼痛发生的危险因素.结果 102例腹腔镜胆囊切除术患者中有32例出现慢性疼痛,发生率为31.4％.经单因素分析,2组患者的体质指数(BMI)、吸烟史、饮酒史、基础疾病史、文化程度、职业、原发疾病、美国麻醉医师学会(ASA)分级、住院时间、术后1 d疼痛评分比较差异无统计学意义(P＞0.05);慢性疼痛组患者年龄小于无痛组(t=6.220,P＜0.001),女性患者比例(x2=4.678,P=0.030)、手术时间(t=4.473,P＜0.001)、术后C反应蛋白(CRP)(t=7.580,P＜0.001)、术后感染发生率(x2=15.167,P＜0.001)均高于无痛组.经logistic多因素分析,年龄小、女性、术后CRP水平高、术后合并感染、手术时间长是腹腔镜胆囊切除术患者术后慢性疼痛的影响因素[OR 值(95％CI)=1.432(1.341,1.787)、1.623(1.454,1.898)、1.961(1.813,2.132)、1.802(1.731,2.092)、1.354(1.223,1.401),P值分别为 0.004、0.002、＜0.001、0.001、0.006].结论 腹腔镜胆囊切除术后有较高的慢性疼痛发生率,其中女性、年龄小、手术时间长、术后合并感染、术后CRP水平高均为腹腔镜胆囊切除术后慢性疼痛的危险因素.
Abstract
Objective To analyze and study the risk factors for chronic pain after laparoscopic cholecystectomy.Methods One hundred and two patients who underwent laparoscopic cholecystectomy in the Department of General Surgery at Ganxi Hospital in Pingxiang City,Jiangxi Province from January 1,2019 to January 1,2024 were selected as the research subjects.All patients completed laparoscopic cholecystectomy and were followed up in the outpatient department for 2 months after surgery.The pain level of patients was evaluated using the visual analog scale(VAS),and the incidence of chronic pain after surgery was calculated based on the score.Patients were divided into a chronic pain group and a painless group.We conducted a questionnaire survey to collect general and clinical information of patients,and analyzed the risk factors for chronic pain after laparoscopic cholecystectomy using univariate and multivariate logistic regression.Results Among 102 patients undergoing laparoscopic cholecystectomy,32 experienced chronic pain,with an incidence rate of 31.37％.Through univariate analysis,there was no significant difference in body mass index(BMI),smoking history,alcohol consumption history,underlying disease history,education level,occupation,primary disease,ASA grading,length of hospital stay,and postoperative pain score between the two groups of patients(P＞0.05).Patients in the chronic pain group were younger than those in the painless group(t=6.220,P＜0.001),while female patients(x2=4.678,P=0.030),surgery time(t=4.473,P＜0.001),postoperative C-reactive protein(CRP)(t=7.580,P＜0.001),and postoperative infection rate(x2=15.167,P＜0.001)were all higher than those in the painless group.According to logistic multivariate analysis,young age,high postoperative CRP levels female gender,postoperative co infection,long surgery time,the influencing factors of chronic headache in patients undergoing laparoscopic cholecystectomy[OR(95％CI)=1.432(1.341,1.787),1.623(1.454,1.898),1.961(1.813,2.132),1.802(1.731,2.092),1.354(1.223,1.401),P=0.004,0.002,＜0.001,0.001,0.006].Conclusion There is a high incidence of chronic pain after laparoscopic cholecystectomy,among which female gender,young age,long operation time,postoperative infection,and high postoperative CRP levels are all risk factors for chronic pain after laparoscopic cholecystectomy.
维普
万方数据