微创肺叶切除术后急性中重度疼痛危险因素分析

Evaluation of the Outcome of Acute Moderate-Severe Pain after Minimally Invasive Lobectomy

摘要: 目的：探究微创肺叶切除术后急性中重度疼痛的发生率，并确定相关危险因素。方法：对2017年1月至2019年1月间行微创肺叶切除术的502例成人患者进行回顾性队列分析。以数字评分法(Numeric Rating Scale, NRS)评定患者术后48小时的疼痛程度，按照术后疼痛程度分为轻度疼痛组(NRS < 4)和中重度疼痛组(NRS ≥ 4)；对微创肺叶切除术患者术后急性中重度疼痛的影响因素分别进行单因素及多因素Logistic 回归分析。结果：术后48小时中重度疼痛发生率为20.52%。多因素分析中，术后48小时中重度疼痛的独立危险因素为年龄(OR 1.027 95%CI 1.003~1.051, P = 0.029)和手术时间(OR 0.994 95%CI 0.990~0.999, P = 0.010)。结论：微创性肺叶切术后急性中重度疼痛的发生率较高，需要制定相关危险因素的防治策略，以提高肺癌患者术后生活质量，促进术后康复。

Abstract: Objective: To investigate the incidence of acute moderate-severe pain after minimally invasive lobectomy and to determine the associated risk factors. Methods: A retrospective cohort analysis was performed on 502 adult patients who underwent minimally invasive lobectomy between January 2017 and January 2019. The pain degree of patients 1 - 2 days after surgery was evaluated by numerical scoring method. According to the degree of postoperative pain, patients were divided into mild pain group and moderate-severe pain group. Univariate Logistic regression analysis and multivariate Logistic regression analysis were performed on the influencing factors of postoperative acute moderate-severe pain in patients with minimally invasive lobectomy. Results: Moderate-severe pain occurred 48 hours after surgery in 20.52%. In the multivariate analysis, the independent risk factors associated with moderate-severe pain 48 h postoperatively were age (OR 1.027 95%CI 1.003 - 1.051, P = 0.029) and duration of surgery (OR 0.994 95%CI 0.990 - 0.999, P = 0.010). Conclusions: The incidence of acute moderate-severe pain after minimally invasive radical resection of lung cancer is still not low, and related risk factors need to develop prevention and treatment strategies, so as to improve the quality of life of lung cancer patients and promote postoperative rehabilitation.