四肢骨折患者术后中度至重度疼痛发生率的回顾性研究及影响因素分析

A Retrospective Study on the Incidence of Moderate to Severe Postoperative Pain in Patients with Limb Fractures and Analysis of Influencing Factors

摘要: 目的：探讨四肢骨折患者术后中度至重度疼痛的发生率及其独立影响因素，为制定针对性的镇痛策略提供依据。方法：采用回顾性研究方法，选取2020年1月至2025年6月某院收治的70例符合标准的四肢骨折手术患者。通过医院信息系统收集资料，采用数字评分法(NRS)评估疼痛，NRS ≥ 4分为中重度疼痛。采用单因素分析及多因素Logistic回归分析筛选术后中重度疼痛的独立影响因素。结果：本研究纳入的70例患者中，术后中重度疼痛的总体发生率为60.0%，峰值出现在术后24小时(54.29%)。多因素Logistic回归分析显示，年龄增长(OR = 1.07)、有吸烟史(OR = 5.09)、手术时间延长(OR = 1.03)、术前低白蛋白血症(OR = 0.78)及高中性粒细胞/淋巴细胞比值(NLR, OR = 2.77)是术后中重度疼痛的独立危险因素(P < 0.05)。模型预测效能良好(AUC = 0.87)。结论：四肢骨折患者术后中重度疼痛发生率较高，其发生受年龄、吸烟史、手术时长、营养及炎症状态等多因素影响。临床应针对高危人群早期采取多模式镇痛方案，并加强围术期营养支持和炎症管理，以有效改善患者预后。

Abstract: Objective: To explore the incidence of moderate to severe postoperative pain in patients with limb fractures and its independent influencing factors, and to provide a basis for formulating targeted analgesic strategies. Methods: A retrospective study was conducted. 70 patients who met the criteria and underwent limb fracture surgery in a certain hospital from January 2020 to June 2025 were selected. Data were collected through the hospital information system, and the Numerical Rating Scale (NRS) was used to assess pain. NRS ≥ 4 was classified as moderate to severe pain. Univariate analysis and multivariate Logistic regression analysis were used to screen the independent influencing factors of moderate to severe postoperative pain. Result: Among the 70 patients included in this study, the overall incidence of moderate to severe postoperative pain was 60.0%, with the peak occurring at 24 hours after the operation (54.29%). Multivariate Logistic regression analysis showed that increased age (OR = 1.07), history of smoking (OR = 5.09), prolonged operation time (OR = 1.03), preoperative hypoalbuminemia (OR = 0.78), and high neutrophil/lymphocyte ratio (NLR, OR = 2.77) was an independent risk factor for moderate to severe postoperative pain (P < 0.05). The model has good predictive performance (AUC = 0.87). Conclusion: The incidence of moderate to severe pain after surgery in patients with limb fractures is relatively high, and its occurrence is influenced by multiple factors such as age, smoking history, operation duration, nutrition and inflammatory status. Clinically, multimodal analgesia regimens should be adopted early for high-risk populations, and perioperative nutritional support and inflammation management should be strengthened to effectively improve the prognosis of patients.