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先天性心脏病患儿手术后的慢性疼痛与生活质量。

Post-surgical chronic pain and quality of life in children operated for congenital heart disease.

机构信息

Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Pain Management and Palliative Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Acta Anaesthesiol Scand. 2019 Jul;63(6):745-750. doi: 10.1111/aas.13346. Epub 2019 Mar 14.

DOI:10.1111/aas.13346
PMID:30869169
Abstract

BACKGROUND

Advances in medical technology have resulted in an increased life expectancy in pediatric patients with congenital heart diseases. Assessment of health-related quality of life is crucial to improving their healthcare status. We aimed to assess post-surgical pain prevalence and its impact on health-related quality of life in pediatric patients who underwent cardiac surgery during childhood.

METHODS

This cross-sectional study recruited patients aged 4 years or older who underwent cardiac surgery for congenital heart disease at least 1 year prior, during the age of 0-10 years, and were admitted for post-surgical follow-up at our institute. The prevalence, intensity, and location of pain and health-related quality of life were assessed in an interview. Perioperative information was collected from the patients' medical records. Health-related quality of life was assessed using the Pediatric quality of life inventory 4.0 (PedsQL).

RESULTS

Pain was reported by 24 (17%) of the 141 participants. One-third of them reported moderate to severe pain that required medical intervention. After adjustment for several confounding factors, multivariable linear regression analysis demonstrated that the presence of pain and the number of surgeries were associated with lower total PedsQL scores.

CONCLUSIONS

Pain was present in 17% of the patients who underwent cardiac surgery during childhood. Presence of pain had a negative impact on long-term health-related quality of life after pediatric cardiac surgery.

摘要

背景

医疗技术的进步使患有先天性心脏病的儿科患者的预期寿命延长。评估与健康相关的生活质量对于改善他们的医疗保健状况至关重要。我们旨在评估接受过心脏手术的儿科患者手术后疼痛的发生率及其对生活质量的影响。

方法

本横断面研究招募了至少在 1 年前、0-10 岁期间因先天性心脏病接受过心脏手术且在我院接受术后随访的年龄为 4 岁或以上的患者。通过访谈评估疼痛的发生率、强度和位置以及与健康相关的生活质量。围手术期信息从患者的病历中收集。使用儿科生活质量问卷 4.0(PedsQL)评估与健康相关的生活质量。

结果

在 141 名参与者中,有 24 名(17%)报告有疼痛。其中三分之一的人报告有需要医疗干预的中度至重度疼痛。在调整了几个混杂因素后,多变量线性回归分析表明,疼痛的存在和手术次数与较低的总体 PedsQL 评分相关。

结论

在接受过儿童心脏手术的患者中,有 17%的患者存在疼痛。疼痛的存在对儿童心脏手术后的长期健康相关生活质量有负面影响。

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