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Analysis of influencing factors of chronic post-surgical pain after total hip replacement in the elderly |
SHEN Weiming GAO Bing CHEN Jie |
Department of Orthopedics,Zhangzhou People′s Hospital,Fujian Province,Zhangzhou 363000,China |
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Abstract Objective To explore the influencing factors of chronic post-surgical pain(CPSP)after total hip arthroplasty in the elderly.Methods A total of 124 elderly patients who underwent total hip arthroplasty in Zhangzhou People′s Hospital from January 2015 to December 2020 were selected as the research objects.The occurrence of CPSP within 6 months after operation was evaluated by digital evaluation scale(NRS).The occurrence of CPSP was taken as the dependent variable,the American Association of Anesthesiologists(ASA)grade,operation time,postoperative analgesia,postoperative 24 h NRS score and general data were analyzed.Results Univariate analysis showed that age,body mass index(BMI),drinking history,operation time,hip joint starting time,postoperative analgesia mode,postoperative 24 h NRS score and deep venous thrombosis of lower extremities were related factors affecting CPSP.Multivariate analysis showed that the starting time of hip joint movement ≥3 d(β=-0.917, OR=0.629,95%CI=0.406-0.861)was the protective factor of CPSP,while age ≥70 years old(β=-0.728, OR=0.721,95%CI=0.593-0.832),BMI ≥28 kg/m2(β=0.754,OR=3.253,95%CI=2.061-8.092),operation time >2 h(β=1.734,OR=5.269,95%CI=2.381-12.962),deep vein thrombosis of lower extremities(β=1.208, OR=6.872,95%CI=4.724-12.736)and postoperative 24 h NRS score >3 points(β=1.820, OR=6.284,95%CI=2.593-14.872)were independent risk factors for CPSP(P<0.05).Conclusion Age >70 years old,obesity,long operation time,postoperative deep venous thrombosis of lower extremities and postoperative 24 h NRS score >3 points are risk factors for CPSP after total hip arthroplasty in the elderly.Hip joint movement time ≥3 days is a protective factor for CPSP after total hip arthroplasty in the elderly.
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Received: 24 November 2021
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[4] |
冯康平,张新建,张春艳.骨科手术后慢性疼痛发生的危险因素分析及预测模型构建[J].职业与健康,2017,33(20):2877-2880.
|
[5] |
杨娟,冯智英.术后慢性疼痛流行病学及风险因素的研究进展[J].国际麻醉学与复苏杂志,2017,38(2):179-184.
|
[6] |
陈军,王江林.国际疼痛学会对世界卫生组织ICD-11 慢性疼痛分类的修订与系统化分类[J].中国疼痛医学杂志,2019,25(5):323-330.
|
[1] |
蒙小燕,湛琅,张雪梅.急症创伤骨科患者术后疼痛影响因素评估及个体化护理[J].齐鲁护理杂志,2008,14(4):19-20.
|
[2] |
王烨,江涛,李丁,等.骨质疏松性椎体压缩骨折PKP 术后疼痛不缓解的原因分析[J].实用骨科杂志,2019,25(4):350-352.
|
[3] |
杨红萍.多模式疼痛管理对骨科术后患者疼痛程度、预后效果及护理满意度的影响[J].中华现代护理杂志,2019,25(31):4106-4109.
|
[7] |
汤冰玥,楼燕凤.疼痛护理联合知识宣教对带状疱疹后遗神经痛患者NRS 评分的影响[J].长春中医药大学学报,2020,36(1):177-179.
|
[8] |
杨武,唐锡国,唐锡辉,等.初次全髋关节置换术后髋关节疼痛发生影响因素分析[J].中华关节外科杂志(电子版),2019,13(4):396-400.
|
[9] |
兰岭,申乐,黄宇光.术后慢性疼痛相关炎症反应及炎症细胞因子研究进展[J].中国医学科学院学报,2015,37(6):741-745.
|
[10] |
雷洋,林源,曹玉强,等.血清炎症因子与髋关节置换手术后患者慢性疼痛的相关性[J].西部医学,2021,33(2):249-253.
|
[11] |
张光辉,王存川.中国肥胖及2型糖尿病外科治疗指南(2019 版)解读[J].临床外科杂志,2020,28(1):46-48.
|
[12] |
费晨,魏巍,张斌飞,等.胫骨平台骨折患者围手术期下肢深静脉血栓形成发生规律及危险因素分析[J].中华创伤骨科杂志,2019,21(2):102-108.
|
[13] |
张苏立,葛红艳,叶萍.肥胖对患者初次全髋关节置换术后护理疗效及预后的影响[J].当代护士(上旬刊),2020,27(12):97-98.
|
[14] |
朱江龙,陈跃平,董盼锋,等.老年骨质疏松症患者髋关节置换术后预后及相关因素分析[J].中国骨质疏松杂志,2019,25(8):1073-1077.
|
[15] |
张荣.中医护理干预对人工髋关节置换术后患者髋关节疼痛及功能活动的影响[J].长春中医药大学学报,2017,33(6):971-973.
|
[16] |
杨玉春,汪小海,张咏梅,等.老年患者全麻下全髋置换术后下肢深静脉血栓发生情况及危险因素[J].局解手术学杂志,2019,28(2):108-111.
|
[17] |
李瑞琳,郭一尘.丁苯酞对ACI 患者血清炎性因子、氧化应激及神经营养因子的影响[J].海南医学院学报,2018,24(1):113-116,120.
|
[18] |
刘书华,徐浩,朱晓波,等.关节周围鸡尾酒镇痛药物注射对髋关节置换术后疼痛程度及早期功能锻炼的影响[J].浙江医学,2021,43(1):89-93.
|
[19] |
孙跃先,于晶,庄天微,等.直接前入路全髋关节置换术对老年股骨颈骨折患者术后康复的效果观察[J].中国医药科学,2021,11(2):206-208,222.
|
|
|
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