目的 探讨肩关节镜术后疼痛的特点及其慢性化的相关危险因素。方法 回顾性分析2021年1-12月在解放军总医院第一医学中心骨科行肩关节镜手术患者资料。收集患者一般资料及手术相关信息,利用疼痛数字化评分(NRS)评估术前,术后1 d、 3 d,以及术后3个月的静止痛。将手术引起、继发于术后急性疼痛且持续时间超过3个月的疼痛定义为术后慢性疼痛,利用Logistics回归分析年龄、性别、体质量指数(BMI)、术前诊断、病程时间、手术方式、术前和术后 3 d静止疼痛程度、手术涉及肩部结构数及手术次数等因素与术后慢性疼痛的相关性。结果 本研究共纳入患者300例(男170例,女130例),不同程度术前静止痛各组之间在术后1 d、 3 d及3个月时均无统计学差异(F=1.609,P=0.194)。术后3个月NRS评分较术前,术后1、 3 d显著降低(P＜0.05),其中年龄≥50岁、SLAP损伤、肱二头肌长头肌切断或整形修复术、术后 3 d静止疼痛≥5分、手术次数≥2次及病程≥12个月与术后慢性疼痛的发生显著相关(P<0.05)。结论 SLAP损伤、肱二头肌长头肌切断或整形修复术、术后 3 d静止痛程度、手术次数及病程是术后慢性疼痛发生的相关危险因素。
Abstract
Objective To explore the characteristics of postoperative pain after shoulder arthroscopy and its associated risk factors for chronicity. Methods The data of patients who underwent orthopedic shoulder arthroscopic surgery at the First Medical Center of PLA General Hospital from January to December 2021 were retrospectively analyzed. General patient data and surgery-related information were collected, and resting pain was assessed preoperatively, 1 day and 3 days after surgery, and 3 months after surgery using the Numerical Pain Score (NRS). Surgery-induced pain that was secondary to acute postoperative pain and lasted longer than 3 months was defined as postoperative chronic pain. Logistic Regression was used to analyze the correlations between age, gender, body mass index (BMI), preoperative diagnosis, duration of disease, surgical method, degree of preoperative and 3-day resting pain, number of shoulder structures involved in the procedure, and number of surgeries and factors and postoperative chronic pain. Results A total of 300 patients (170 males and 130 females) were included in this study. There were no statistically significant differences in preoperative resting pain among different groups at postoperative days 1 and 3, or at 3 months (F=1.609,P=0.194). The NRS score at 3 months after surgery was significantly lower than that before surgery, 1 day, and 3 days after surgery (P<0.05). Age ≥ 50 years, SLAP injury, biceps long head muscle resection or repair surgery, 3-day postoperative resting pain≥5 points, number of surgeries ≥2, and duration of disease ≥12 months were significantly associated with the occurrence of postoperative chronic pain (P<0.05). Conclusions Age≥50 years, SLAP injury, biceps long head muscle resection or repair surgery, postoperative resting pain degree at 3 days, number of surgeries and duration of disease are associated risk factors for postoperative chronic pain.
关键词
关节镜 /
肩关节 /
术后慢性疼痛 /
SLAP损伤 /
疼痛数字化评分
Key words
arthroscopy /
shoulder joint /
postoperative chronic pain /
SLAP injury /
numeric rating scale
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