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腹腔镜子宫切除术与腹式子宫切除术之间慢性术后疼痛的患病率和强度无差异:一项前瞻性研究。

No Differences in the Prevalence and Intensity of Chronic Postsurgical Pain Between Laparoscopic Hysterectomy and Abdominal Hysterectomy: A Prospective Study.

作者信息

Jin Juying, Min Su, Peng Lihua, Du Xunsong, Zhang Dong, Ren Li

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.

出版信息

J Pain Res. 2020 Jan 7;13:1-9. doi: 10.2147/JPR.S225230. eCollection 2020.

Abstract

OBJECTIVE

To compare the prevalence and characteristics of chronic postsurgical pain (CPSP) between laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH) groups 3, 6, and 12 months after surgery, and to assess the impact of pain on the activities of daily living (ADL) of patients.

METHODS

The demographic characteristics, intraoperative clinical factors, and postoperative pain score were collected prospectively in patients scheduled for elective LH or AH for benign disease at our institution from July 2014 to June 2015. Patients were interviewed by telephone and followed up for pain assessment 3, 6, and 12 months after surgery. The prevalence, intensity, and specific locations of pain, as well as analgesic administration and impact on the ADL, were included in the questionnaire.

RESULTS

The results from 406 patients (225 patients in the LH group and 181 patients in the AH group) were obtained. Three months after surgery, the prevalence of CPSP was 20.9% in the LH group and 20.4% in the AH group. At 6 months, the prevalence of pain declined to 11.6% in the LH group and 9.4% in the AH group. At 12 months after surgery, only 13 (5.8%) patients in the LH group and 11 (6.1%) patients in the AH group complained about persistent pain. The prevalence of CPSP, as well as the average numerical rating scale pain scores at rest and during movement, during 12 months after surgery were not significantly different between the groups. CPSP after hysterectomy exhibited a negative impact on the ADL.

CONCLUSION

The prevalence and intensity of CPSP were not significantly different between patients undergoing LH or AH within 12 months after surgery. A tendency towards a reduction in chronic pain over time was documented. Chronic post-hysterectomy pain exhibited a negative impact on the ADL.

摘要

目的

比较腹腔镜子宫切除术(LH)组和腹式子宫切除术(AH)组术后3个月、6个月和12个月慢性术后疼痛(CPSP)的患病率及特征,并评估疼痛对患者日常生活活动(ADL)的影响。

方法

前瞻性收集2014年7月至2015年6月在我院因良性疾病计划行择期LH或AH的患者的人口统计学特征、术中临床因素及术后疼痛评分。通过电话对患者进行访谈,并在术后3个月、6个月和12个月进行疼痛评估随访。问卷包括疼痛的患病率、强度、具体部位,以及镇痛药物使用情况和对ADL的影响。

结果

获得了406例患者(LH组225例,AH组181例)的结果。术后3个月,LH组CPSP患病率为20.9%,AH组为20.4%。6个月时,LH组疼痛患病率降至11.6%,AH组降至9.4%。术后12个月,LH组仅13例(5.8%)患者、AH组仅11例(6.1%)患者主诉持续疼痛。两组术后12个月内CPSP患病率以及静息和活动时的平均数字评分量表疼痛评分无显著差异。子宫切除术后的CPSP对ADL有负面影响。

结论

LH或AH术后12个月内患者CPSP的患病率和强度无显著差异。记录显示慢性疼痛有随时间减少的趋势。子宫切除术后慢性疼痛对ADL有负面影响。

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