[慢性血液透析患者慢性疼痛的评估与分析]

[The evaluation and analysis of chronic pain in chronic hemodialysis patients].

作者信息

Bouattar Tarik, Skalli Zoubair, Rhou Hakima, Ezzaitouni Fatima, Ouzeddoun Naima, Bayahia Rabia, Benamar Loubna

机构信息

Service de néphrologie, dialyse, transplantation rénale, CHU Ibn Sina, Rabat, Maroc.

出版信息

Nephrol Ther. 2009 Dec;5(7):637-41. doi: 10.1016/j.nephro.2009.06.004. Epub 2009 Jul 21.

DOI:10.1016/j.nephro.2009.06.004

PMID:19625232

Abstract

INTRODUCTION

Pain is a sensorial experience and emotional discomfort associated with a potential tissue damage or described in terms evoking such injuries. Its management is a task for every physician. However, the epidemiology and characteristics of pain among chronic hemodialysis patients are incompletely defined. PURPOSE OF OUR STUDY: To evaluate the prevalence, characteristics, impact and treatment of chronic pain in chronic hemodialysis and its potential risk factors.

METHODS

A cross-sectional study included 67 chronic hemodialysis patients in the Ibn Sina Hospital hemodialysis center in Rabat. We evaluated the sociodemographic characteristics of patients and pain features, as well as the response to analgesics. Pain is described as chronic when it persists for more than 3 months. The pain intensity was specified by a verbal scale.

RESULTS

The mean age of our patients was 43.5+/-12.9 years with a feminine predominance (58.2%). The prevalence of pain was 50.7%. The pain was noticed for a mean period of 21 months (six to 60). This pain was continuous, frequent, intermittent and rare in respectively 20.6, 17.6, 47.1 and 14.7% of cases. The intensity of the pain was low in 3%, moderate in 41%, severe in 44% and very severe in 12% of cases. An osteoarticular origin was found in 76.5% of cases. A physical activity disorder was found in 67.6% of cases. Half of our patients were taking analgesics in 23.5% of cases, as daily use in 29.7% of cases frequently, and in 47.1% of cases rarely. These analgesics were level 1 in 47.1% and level 2 in 52.9% of cases. The therapeutic response is characterized by the disappearance of pain in 35.5% of cases. During dialysis sessions, pain intensity was the same in 79.4% of the patients. The risk factors associated with pain were an advanced age and a long length of time on dialysis.

CONCLUSION

A systematic evaluation of pain is required to improve the quality of life of hemodialysis patients.

摘要

引言

疼痛是一种与潜在组织损伤相关的感觉体验和情绪不适，或以引发此类损伤的术语来描述。疼痛管理是每位医生的任务。然而，慢性血液透析患者疼痛的流行病学和特征尚未完全明确。我们研究的目的：评估慢性血液透析患者慢性疼痛的患病率、特征、影响、治疗及其潜在危险因素。

方法

一项横断面研究纳入了拉巴特伊本·西那医院血液透析中心的67例慢性血液透析患者。我们评估了患者的社会人口学特征、疼痛特征以及对镇痛药的反应。当疼痛持续超过3个月时被描述为慢性疼痛。疼痛强度通过语言量表确定。

结果

我们患者的平均年龄为43.5±12.9岁，女性占主导（58.2%）。疼痛患病率为50.7%。疼痛平均持续时间为21个月（6至60个月）。这种疼痛分别在20.6%、17.6%、47.1%和14.7%的病例中为持续性、频繁性、间歇性和罕见性。3%的病例疼痛强度低，41%为中度，44%为重度，12%为非常重度。76.5%的病例疼痛起源于骨关节。67.6%的病例存在身体活动障碍。23.5%的病例中有一半患者服用镇痛药，29.7%的病例为每日频繁使用，47.1%的病例为很少使用。这些镇痛药在47.1%的病例中为1级，52.9%的病例中为2级。35.5%的病例治疗反应表现为疼痛消失。在透析过程中，79.4%的患者疼痛强度相同。与疼痛相关的危险因素是高龄和透析时间长。