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多囊肾病患者的疼痛模式。

Pain patterns in patients with polycystic kidney disease.

作者信息

Bajwa Zahid H, Sial Khuram A, Malik Atif B, Steinman Theodore I

机构信息

Department of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Kidney Int. 2004 Oct;66(4):1561-9. doi: 10.1111/j.1523-1755.2004.00921.x.

Abstract

BACKGROUND

Pain is a common problem in patients with polycystic kidney disease (PKD), but patterns have not been characterized as to frequency and severity. Physicians should be aware of pain problems so an approach to chronic pain management can be pursued.

METHODS

One hundred seventy-one completed questionnaires out of 300 distributed to PKD patients whose renal function ranged from normal to end-stage renal disease (ESRD) were analyzed. Age at diagnosis of PKD was documented, and patients noted how the diagnosis was made. Location, severity, and frequency of pain were characterized. The Visual Analogue Scale (VAS) was used to measure pain intensity.

RESULTS

There were 94 females and 77 male respondents, with a mean age of 47.4 years. Initial diagnosis of PKD occurred at a mean age of 31.6 years. Caucasians comprised 92.2% of the respondents. Patients' symptoms, a family history of PKD, and discovery of PKD during evaluation for hypertension or hematuria were the most frequent factors that led to the diagnosis. Order of frequency of pain was: low back pain, abdominal pain, headache, chest pain, and leg pain. Severity of pain, documented by the VAS intensity, was 4 to 5/10 in the majority of patients.

CONCLUSION

Pain, which can be diffuse, is the most frequent symptom that led to the diagnosis of PKD in patients who responded to this questionnaire, and occurs with greater frequency than generally appreciated. Physicians need to obtain a detailed history about pain in their PKD population so as to allow an approach to pain management.

摘要

背景

疼痛是多囊肾病(PKD)患者的常见问题,但疼痛的频率和严重程度模式尚未得到描述。医生应了解疼痛问题,以便能够采取慢性疼痛管理方法。

方法

对向肾功能从正常到终末期肾病(ESRD)的PKD患者发放的300份问卷中的171份完整问卷进行了分析。记录PKD诊断时的年龄,并让患者说明诊断是如何做出的。对疼痛的部位、严重程度和频率进行了描述。使用视觉模拟量表(VAS)来测量疼痛强度。

结果

有94名女性和77名男性受访者,平均年龄为47.4岁。PKD的初始诊断平均发生在31.6岁。白种人占受访者的92.2%。患者的症状、PKD家族史以及在高血压或血尿评估期间发现PKD是导致诊断的最常见因素。疼痛频率顺序为:腰痛、腹痛、头痛、胸痛和腿痛。根据VAS强度记录,大多数患者的疼痛严重程度为4至5/10。

结论

在对该问卷做出回应的患者中,疼痛是导致PKD诊断的最常见症状,疼痛可呈弥漫性,且发生频率高于一般认知。医生需要获取其PKD患者群体关于疼痛的详细病史,以便能够采取疼痛管理方法。

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