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[慢性乳房切除术后疼痛]

[Chronic post-mastectomy pain].

作者信息

Málek J, Kurzová A, Ambrus M, Vedral T, Lysý M, Príkazský V

机构信息

Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha.

出版信息

Cas Lek Cesk. 2006;145(3):209-12; discussion 213-4.

Abstract

BACKGROUND

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.

METHODS AND RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法与结果

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)。

结论

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。

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