Málek J, Kurzová A, Ambrus M, Vedral T, Lysý M, Príkazský V
Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha.
Cas Lek Cesk. 2006;145(3):209-12; discussion 213-4.
Surgery results in chronic pain in 7-80 percent. One of the most studied is chronic post-mastectomy pain. The prevalence was 40-50 percent in studies performed abroad. As this problem has not yet been studied in the Czech Republic, a retrospective prevalence study was performed to asses the extent of the problem and risk factors for development of chronic post-mastectomy pain.
After ethic committee approval an anonymous questionnaire was developed and distributed in various oncology department and patients'organisations. Response rate was 100 percent, 330 questionnaires were processed. Chronic post-mastectomy pain (lasting longer than 3 months after surgery) was described by 69 (20.9 per cent) women. The pain was permanent in 17 and transient in 46 cases, not specified in 6 cases. The pain intensity was predominantly mild or moderate. Risk factors were younger age (below 55-60 years, p=0.0098), less extensive surgery (tumourectomy vs. mastectomy, p=0.0017), intensive post operative pain (p=0.0002) and radiotherapy (p=0.0174). Trend in chemotherapy (p=0.0778) was observed.
The prevalence of chronic post-mastectomy pain was lower in our study comparing to studies in other countries. The reason remains obscure in spite of detailed analysis.
手术会导致7%至80%的患者出现慢性疼痛。其中研究最多的是慢性乳房切除术后疼痛。国外研究中的患病率为40%至50%。由于捷克共和国尚未对该问题进行研究,因此开展了一项回顾性患病率研究,以评估慢性乳房切除术后疼痛问题的严重程度及相关危险因素。
经伦理委员会批准后,设计了一份匿名问卷,并在多个肿瘤科和患者组织中分发。问卷回复率为100%,共处理了330份问卷。69名(20.9%)女性描述了慢性乳房切除术后疼痛(术后持续超过3个月)。其中17例疼痛为持续性,46例为短暂性,6例未明确说明。疼痛强度主要为轻度或中度。危险因素包括年龄较小(55 - 60岁以下,p = 0.0098)、手术范围较小(肿瘤切除术与乳房切除术相比,p = 0.0017)、术后疼痛剧烈(p = 0.0002)以及放疗(p = 0.0174)。观察到化疗存在一定趋势(p = 0.0778)。
与其他国家的研究相比,我们的研究中慢性乳房切除术后疼痛的患病率较低。尽管进行了详细分析,但原因仍不明确。