Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Science, Beijing 100730, China.
Chin Med J (Engl). 2012 Sep;125(17):3033-8.
In clinical practice, the mechanisms underlying chronic post-surgical pain (CPSP) remain insufficiently understood. The primary goals of this study were to determine the incidence of chronic pain after thoracic surgery and to identify possible risk factors associated with the development of chronic post-thoracotomy pain in Chinese patients. The secondary goal was to determine whether the difference between pre- and post-operative white blood cell (WBC) counts could predict the prevalence of CPSP after thoracotomy. The impact of chronic pain on daily life was also investigated.
We contacted by phone 607 patients who had undergone thoracotomy at our hospital during the period February 2009 to May 2010. Statistical comparisons were made between patients with or without CPSP.
were ultimately analyzed from 466 qualified patients. The overall incidence of CPSP was 64.5%. Difference between pre- and post-operative WBC counts differed significantly between patients with or without CPSP (P < 0.001) and was considered as an independent risk factor for the development of CPSP following thoracotomy (P < 0.001). Other predictive factors for chronic pain included younger age (< 60 years, P < 0.001), diabetes mellitus (P = 0.023), acute post-operative pain (P = 0.005) and the duration of chest tube drainage (P < 0.001). At the time of interviews, the pain resulted in at least moderate restriction of daily activities in 15% of the patients, of which only 16 patients had paid a visit to the doctor and only three of them were satisfied with the therapeutic effects.
Chronic pain is common after thoracotomy. WBC count may be a new independent risk factoring surgical patients during peri-operative period. Besides, age, diabetes mellitus, acute post-operative pain, and duration of chest tube drainage may also play a role in chronic post-surgical pain occurrence.
在临床实践中，慢性术后疼痛（CPSP）的发病机制仍了解不足。本研究的主要目的是确定中国患者开胸手术后慢性疼痛的发生率，并确定与开胸术后慢性疼痛发展相关的可能危险因素。次要目标是确定白细胞计数（WBC）术前与术后差值是否可以预测开胸术后 CPSP 的发生。还研究了慢性疼痛对日常生活的影响。
我们通过电话联系了 2009 年 2 月至 2010 年 5 月期间在我院接受开胸手术的 607 名患者。比较了有或无 CPSP 的患者之间的统计学差异。
最终分析了 466 名合格患者。CPSP 的总发生率为 64.5%。有或无 CPSP 的患者之间术前与术后 WBC 计数的差异有统计学意义（P < 0.001），且被认为是开胸术后 CPSP 发展的独立危险因素（P < 0.001）。慢性疼痛的其他预测因素包括年龄较小（<60 岁，P < 0.001）、糖尿病（P = 0.023）、急性术后疼痛（P = 0.005）和胸腔引流管留置时间（P < 0.001）。在访谈时，疼痛导致至少 15%的患者日常生活受限，其中只有 16 名患者曾去看医生，只有 3 名患者对治疗效果满意。
开胸手术后疼痛常见。白细胞计数可能是围手术期外科患者的一个新的独立危险因素。此外，年龄、糖尿病、急性术后疼痛和胸腔引流管留置时间也可能在慢性术后疼痛发生中发挥作用。
