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60岁以上患者的慢性疼痛:老年医学视角

[Chronic pain in patients older than 60 years: a view of the geriatrics].

作者信息

Naumov A V, Moroz V I, Khovasova N O, Manevich T M, Balaeva M M, Tkacheva O N

机构信息

Pirogov Russian National Research Medical University, Moscow, Russia; Russian Clinical and Research Center of Gerontology of Pirogov Russian National Research Medical University, Moscow, Russia.

Russian Clinical and Research Center of Gerontology of Pirogov Russian National Research Medical University, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(6):53-59. doi: 10.17116/jnevro201911906153.

Abstract

AIM

To analyze the geriatric status of patients with chronic pain.

MATERIAL AND METHODS

One hundred and sixteen patients of a geriatric unit, aged 75.66±7.98 years (110 women, 94.8%), were studied. All patients underwent general clinical examination and complex geriatric assessment, on the results of which geriatric syndromes were identified. Characteristics of pain syndrome (cause, intensity, localization) are described.

RESULTS

Chronic pain syndrome is identified in 85 (73.3%) patients. Most often pain is localized in large joints (n=44 (51.76%)) and back (n=50 (58.8%)). The intensity of pain was higher in patients with moderate dependence in daily activities compared to those with mild dependence (p<0.05). Pain intensity is associated with the degree of impairment of physical functioning (p<0.05). Patients with chronic pain have more geriatric symptoms (6.8±2.8). More syndromes (9.11±2.37) are identified in patients with marked impairment of physical functioning. The reduction of muscle strength is observed in 45.9% patients with- and 9.7% patients without chronic pain syndrome. The velocity of pace is 0.59 m/s and 0.71 m/s, respectively.

CONCLUSION

The high prevalence of chronic pain in patients of a geriatric unit is shown. The intensity of pain iss higher in patients with moderate dependence in daily activities compared to those with mild dependence. Pain intensity increases with the reduction of patient's physical functioning. Patients with chronic pain more often have dynapenia and significantly lower velocity of pace that indicates the poor outcome in elderly patients.

摘要

目的

分析慢性疼痛患者的老年状况。

材料与方法

对老年病房的116例患者进行研究,年龄为75.66±7.98岁(110例女性,占94.8%)。所有患者均接受了全面的临床检查和综合老年评估,并据此确定了老年综合征。描述了疼痛综合征的特征(病因、强度、部位)。

结果

85例(73.3%)患者被确定患有慢性疼痛综合征。疼痛最常发生在大关节(n = 44(51.76%))和背部(n = 50(58.8%))。与轻度日常生活依赖患者相比,中度日常生活依赖患者的疼痛强度更高(p<0.05)。疼痛强度与身体功能受损程度相关(p<0.05)。慢性疼痛患者有更多的老年症状(6.8±2.8)。身体功能明显受损的患者中发现更多综合征(9.11±2.37)。45.9%的慢性疼痛综合征患者和9.7%无慢性疼痛综合征患者存在肌肉力量下降。步速分别为0.59米/秒和0.71米/秒。

结论

研究显示老年病房患者慢性疼痛的患病率较高。与轻度日常生活依赖患者相比,中度日常生活依赖患者的疼痛强度更高。疼痛强度随患者身体功能的下降而增加。慢性疼痛患者更常出现肌肉无力,步速明显更低,这表明老年患者预后不佳。

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