Lan Cai-Feng, Lin Bi-Hua, Nie Cai-Ling, Guo Xiu-Ling, Zhou Dan-Hong, Lin Yan-Juan
Department of Gynecology and Obstetrics, Fujian Medical University Union Hospital, Fuzhou, 350001, People's Republic of China.
Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, 350001, People's Republic of China.
Int J Gen Med. 2021 Nov 30;14:9023-9029. doi: 10.2147/IJGM.S342735. eCollection 2021.
To investigate the occurrence and influencing factors of moderate to severe pain in patients with cesarean scar pregnancy (CSP) after uterine artery embolization (UAE).
Ninety-eight patients with CSP who underwent UAE in gynecology department of the Fujian Medical University Union Hospital from January 2017 to December 2020 were enrolled, and the specialty data in patients were collected for pain assessment with the adoption of the numerical rating scale (NRS).
Moderate to severe pain occurred in 36 patients after surgery, and the interquartile of time to the first onset of postoperative pain in patients was 3.04 (1.75, 7.40) hours. The number of pregnancies, number of miscarriages, human chorionic gonadotropin (HCG) before curettage, duration of medication before UAE, and hemorrhage after UAE were not significantly correlated with the occurrence of moderate to severe pain after UAE (P > 0.05). The volume of gestational sac and days of gestation were responsible for the occurrence of moderate to severe pain after UAE (P < 0.05), with the former being the main influencing factor, and these explained 8.3% of the total variance.
Moderate to severe pain occurred commonly in patients with CSP undergoing UAE. In clinical care of patients with CSP who are going to undergo UAE, data concerning the volume of gestational sac and days of gestation should be considered for anticipatory pain assessment, and interventions should be implemented as early as possible to reduce the pain and improve the experience of care.
探讨剖宫产瘢痕妊娠(CSP)患者子宫动脉栓塞术(UAE)后中重度疼痛的发生情况及影响因素。
选取2017年1月至2020年12月在福建医科大学附属协和医院妇科接受UAE治疗的98例CSP患者,收集患者的专科资料,采用数字评分量表(NRS)进行疼痛评估。
术后36例患者发生中重度疼痛,患者术后首次疼痛发作时间的四分位数间距为3.04(1.75,7.40)小时。妊娠次数、流产次数、刮宫术前的人绒毛膜促性腺激素(HCG)、UAE术前用药时间及UAE术后出血与UAE术后中重度疼痛的发生无显著相关性(P>0.05)。孕囊体积和孕周是UAE术后中重度疼痛发生的影响因素(P<0.05),前者为主要影响因素,二者可解释总变异的8.3%。
接受UAE治疗的CSP患者常发生中重度疼痛。在对拟行UAE治疗的CSP患者进行临床护理时,应考虑孕囊体积和孕周的数据进行前瞻性疼痛评估,并尽早实施干预措施以减轻疼痛,改善护理体验。