术前静脉采血穿刺疼痛评估预测全髋关节置换术后疼痛程度的价值

The Value of Preoperative Puncture Pain Assessment in Predicting Pain Levels after Total Hip Arthroplasty

摘要: 全髋关节置换术(Total hip arthroplasty, THA)为终末期退行性髋骨关节炎患者提供可靠的效益，特别是缓解髋关节疼痛、功能恢复和整体生活质量改善。全髋关节置换术术后疼痛是一个经常被报道的不良反应，预防关节置换术后疼痛在治疗方案里显得尤为重要。目的：通过术前穿刺刺激进行视觉模拟评分(visual analogue scale, VAS)，依靠评分分组，对比术后静息状态和运动状态下VAS评分变化。方法：选取了青岛大学附属医院2023年11月至2024年3月入住我院初次行THA的患者98例，依据术前采血时穿刺疼痛进行分组，分别记录术后第1天、第2天、第3天时患者静息和运动的VAS评分，p < 0.05有统计学意义。结果：不同术前VAS评分的患者术后VAS评分不同，术前VAS评分低的患者术后VAS评分也会低，术前3分、4分的患者术后静息痛VAS的第1天、第2天、第3天的评分较1分患者队列分值增高，且差异有统计学意义(p < 0.05)。5分组的运动痛VAS评分在术后第1天，第2天时高于1分组和2分组，且差异具有统计学意义(p < 0.05)，但在术后第3天时差异不明显，且无统计学意义。结论：术前VAS评分低的患者术后VAS评分也会低，术前评估患者VAS评分可一定程度上预测术后VAS评分。

Abstract: Total hip arthroplasty (THA) has provided reliable benefits for patients with end-stage degenerative osteoarthritis (OA) of the hip, Postoperative pain after THA is a frequently reported adverse effect, and prevention of postoperative pain after arthroplasty is particularly important in the treatment program. Objective: We performed visual analogue scale (VAS) scores by preoperative puncture stimulation, relied on the scores for grouping, compared the changes in VAS scores in the resting and exercise states after surgery. Ninety-eight patients who were admitted to the Affiliated Hospital of Qingdao University from November 2023 to March 2024 for primary THA in our hospital were selected. Method: The patients were grouped based on the pain of puncture during preoperative blood collection, and the VAS scores at rest and exercise were recorded at 1d, 2d, and 3d postoperatively. P < 0.05 indicates statistical significance. Results: Postoperative VAS scores differed between patients with different preoperative VAS scores. Patients with low preoperative VAS scores had low postoperative VAS scores. Postoperative resting pain VAS scores at 1d, 2d, and 3d were increased in patients with preoperative scores of 3 and 4 compared with the cohort of patients with score of 1, and the difference was statistically significant (p < 0.05). The dynamic pain VAS scores of subgroup 5 were higher than those of subgroup 1 and subgroup 2 at 1d, 2d postoperatively, and the difference was statistically significant (p < 0.05), but the difference was not significant and not statistically significant at 3d. Conclusions: Patients with low preoperative VAS scores will also have low postoperative VAS scores, and preoperative assessment of patients' VAS scores can predict postoperative VAS scores to some extent.