四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素分析

目的:研究四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素。方法:以2014年12月-2017年10月于我院接受四肢骨折矫形术患者300例为研究对象,于术后6个月分析慢性手术后疼痛的发生率。收集所有患者年龄、性别、体重、术前疼痛程度、二次手术、麻醉方式、术后镇痛、术后引流、合并骨质疏松、骨折类型以及骨折部位等资料,并采用单因素以及多因素Logistic回归分析术后疼痛的危险因素。结果:术后6个月内有96名患者术后发生慢性手术后疼痛,发生率为32.00%(96/300)。单因素分析结果显示:慢性手术后疼痛患者与术前疼痛程度、是否二次手术、麻醉方式、术后有无镇痛、是否合并骨质疏松、骨折类型、骨折部位有关(P0.05),与患者的性别、年龄、体重、术后是否引流无关(P0.05)。多因素Logistic回归分析结果显示:术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均是四肢骨折矫形术后发生慢性手术后疼痛的独立危险因素(P0.05)。结论:四肢骨折矫形术后患者慢性手术后疼痛的发生率较高,术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均增加了慢性手术后疼痛的发生风险,临床应根据危险因素给予针对性的干预措施。

Analysis of Incidence and Risk Factors of Postoperative Chronic Pain after Orthopedic Surgery for Limbs Fractures

ABSTRACT Objective: To study the incidence and risk factors of postoperative chronic pain after orthopedic surgery for limbs fractures. Methods: 300 patients who were received orthopedic surgery for limbs fractures in our hospital from December 2014 to October 2017 were selected as the research subjects, and the incidence of postoperative chronic pain was analyzed at 6 months after surgery. Age, gender, weight, preoperative pain degree, secondary surgery, type of anesthesia, postoperative analgesia, postoperative drainage, complicated osteoporosis, type of fracture and fracture site of patients were collected. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of postoperative pain. Results: 96 patients experienced postoperative chronic pain within 6 months after surgery, and the incidence was 32.00% (96/300). The results of single factor analysis showed that patients with chronic postoperative pain were associated with preoperative pain degree, secondary surgery or not, type of anesthesia, postoperative analgesia or not, complicated osteoporosis or not, type of fracture, fracture site (P<0.05), it was not related to gender, age, weight and postoperative drainage (P>0.05). The results of multiple factor Logistic regression analysis showed that preoperative severe pain, secondary surgery, anaesthesia for non general anesthesia, no analgesia after surgery, complicated osteoporosis, open fracture and lower limb fracture were independent risk factors for postoperative chronic pain after orthopedic surgery for limbs fractures(P<0.05). Conclusion: The incidence of chronic postoperative pain is higher after orthopedic surgery for limbs fractures. Preoperative severe pain, secondary surgery and anesthesia for non general anesthesia, no analgesia after surgery, complicated osteoporosis, open fracture and lower limb fracture increase the risk of postoperative chronic pain, clinical interventions should be targeted according to risk factors.