Paul Julia
William Beaumont Hospital, Royal Oak, MI 48073, USA.
Ostomy Wound Manage. 2013 Jul;59(7):28-34.
Persons with chronic wounds may experience wound-related itch (pruritus) and pain. A cross-sectional study was conducted to examine the occurrence of itch and pain in chronic wounds and the relationship of the intensity between these factors. Patients in an outpatient wound care center, 18 years and older with an open wound, were recruited consecutively over a 5-month period. The 199 participants (112 [56%] men) had a mean age of 67 years (range 21-98 years); one wound per person was addressed and included venous (31), arterial (23), neuropathic (31), pressure-related (33), traumatic (37), and "other" (41) wounds. Wound-related pain and itch data were obtained using a modified Paul-Pieper Itching Questionnaire and Characteristics of Itch Questionnaire. Responses were hand-recorded and coded without personal identifiers and analyzed using descriptive statistics, and associations among data were assessed using Pearson chi-square, Mantel-Haenszel chi-square, and Cochran-Armitage trend tests. Wound-related itch was significantly associated with participant age (P = 0.011) and employment status (P = 0.003). Wound-related pain was significantly associated only with education level (P = 0.048). Persons with venous wounds had both the largest proportion with wound-related itch (45.2%) and the largest proportion with wound-related pain (61.2%) out of all of the wound types. Persons with diabetic neuropathy had both the smallest proportion with wound-related itch (16.1%) and the smallest proportion with wound-related pain (35.4%) among all of the wound types. Associations between wound type and wound-related itch or pain were not significant. When venous wounds were compared to all other wound types combined, wound-related itch was significantly associated (P = 0.021) with wound type - ie, venous wound type and itch was statistically significant when venous wounds were compared to a combination of all other wound types. Wound-related pain and itch occurred together in 35 participants (17.6%) across all wound types. Pain and itch on the wound were significantly associated (r = .36, P = 0.043), as were pain and itch around the wound (r = .43, P = 0.002). Because pain and itching can occur with chronic wounds and the presence of one factor can affect the other, clinicians need to assess and manage both symptoms in patients with wounds.
患有慢性伤口的人可能会经历与伤口相关的瘙痒（瘙痒症）和疼痛。进行了一项横断面研究，以检查慢性伤口中瘙痒和疼痛的发生率以及这些因素之间强度的关系。在一个门诊伤口护理中心，连续5个月招募了18岁及以上有开放性伤口的患者。199名参与者（112名[56%]男性）的平均年龄为67岁（范围21 - 98岁）；每人处理一个伤口，包括静脉性（31个）、动脉性（23个）、神经性（31个）、压力性（33个）、创伤性（37个）和“其他”（41个）伤口。使用改良的保罗 - 皮珀瘙痒问卷和瘙痒特征问卷获取与伤口相关的疼痛和瘙痒数据。回答被手工记录并编码，不包含个人标识符，并使用描述性统计进行分析，数据之间的关联使用Pearson卡方检验、Mantel - Haenszel卡方检验和 Cochr an - Armitage趋势检验进行评估。与伤口相关的瘙痒与参与者年龄（P = 0.011）和就业状况（P = 0.003）显著相关。与伤口相关的疼痛仅与教育水平显著相关（P = 0.048）。在所有伤口类型中，静脉性伤口患者中与伤口相关瘙痒的比例最高（45.2%），与伤口相关疼痛的比例也最高（61.2%）。在所有伤口类型中，糖尿病性神经病变患者中与伤口相关瘙痒的比例最小（16.1%），与伤口相关疼痛的比例也最小（35.4%）。伤口类型与伤口相关瘙痒或疼痛之间的关联不显著。当将静脉性伤口与所有其他伤口类型合并进行比较时，与伤口相关的瘙痒与伤口类型显著相关（P = 0.021）——即当将静脉性伤口与所有其他伤口类型的组合进行比较时，静脉性伤口类型与瘙痒在统计学上具有显著意义。在所有伤口类型中，35名参与者（17.6%）同时出现与伤口相关的疼痛和瘙痒。伤口上的疼痛和瘙痒显著相关（r = 0.36，P = 0.043），伤口周围的疼痛和瘙痒也显著相关（r = 0.43，P = 0.002）。由于慢性伤口可能会出现疼痛和瘙痒，且一个因素的存在可能会影响另一个因素，临床医生需要评估和管理伤口患者的这两种症状。
