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心脏手术后的慢性疼痛:一项前瞻性研究。

Chronic pain after cardiac surgery: a prospective study.

机构信息

St Elisabeth Department of Cardiothoracic Surgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

出版信息

Acta Anaesthesiol Scand. 2010 Jan;54(1):70-8. doi: 10.1111/j.1399-6576.2009.02097.x. Epub 2009 Aug 13.

Abstract

BACKGROUND

Chronic pain is a complication of several surgical procedures. The prevalence of chronic pain reported after cardiac surgery varies from 18% to 61%. However, most studies are retrospective, do not use validated instruments for pain measurement or include only pain at the sternum site. The aim of the present study was to assess chronic pain and health-related quality of life (HRQOL) after cardiac surgery.

METHODS

In a prospective, population-based study, we included 534 patients (413 males) and assessed chronic pain and HRQOL before, 6 months after, and 12 months after cardiac surgery. Pain was measured by the Brief Pain Inventory, while HRQOL was measured by the Short-Form 36 (SF-36).

RESULTS

Five hundred and twenty-one patients were alive 12 months after surgery; 462 (89%) and 465 (89%) responded after 6 and 12 months, respectively. Chronic pain was reported by 11% of the patients at both measurements. Younger age was associated with chronic pain [odds ratio 0.7 (95% confidence interval: 0.5-0.9)] at 12 months. Patients with chronic pain reported lower scores on seven of eight SF-36 subscales.

DISCUSSION

In conclusion, we observed a lower prevalence of chronic pain after cardiac surgery than in previous studies. Still, more than one out of 10 patients reported chronic pain after cardiac surgery. Chronic pain appears to affect HRQOL. Thus, given the large number of patients subjected to cardiac surgery, this study confirms that chronic pain after cardiac surgery is an important health care issue.

摘要

背景

慢性疼痛是多种手术的并发症。心脏手术后慢性疼痛的报告发生率从 18%到 61%不等。然而,大多数研究是回顾性的,没有使用疼痛测量的验证工具,或者只包括胸骨部位的疼痛。本研究旨在评估心脏手术后的慢性疼痛和健康相关生活质量(HRQOL)。

方法

在一项前瞻性、基于人群的研究中,我们纳入了 534 名患者(413 名男性),并在心脏手术后之前、6 个月和 12 个月评估了慢性疼痛和 HRQOL。疼痛通过简短疼痛量表(Brief Pain Inventory)进行测量,而 HRQOL 通过健康调查简表(Short-Form 36,SF-36)进行测量。

结果

521 名患者在手术后 12 个月时存活;462 名(89%)和 465 名(89%)分别在 6 个月和 12 个月后作出了回应。在这两个测量时间点,都有 11%的患者报告存在慢性疼痛。在 12 个月时,年龄较小与慢性疼痛相关(优势比 0.7[95%置信区间:0.5-0.9])。有慢性疼痛的患者在 SF-36 的八个子量表中的七个子量表上的评分较低。

讨论

总之,我们观察到心脏手术后慢性疼痛的发生率低于以往的研究。尽管如此,仍有超过十分之一的患者报告心脏手术后存在慢性疼痛。慢性疼痛似乎会影响 HRQOL。因此,鉴于有大量患者接受了心脏手术,这项研究证实心脏手术后的慢性疼痛是一个重要的医疗保健问题。

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