Nowakowski Matilda E, McCabe Randi E, Busse Jason W
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Chronic Pain Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
Can J Pain. 2019 Jul 30;3(2):59-68. doi: 10.1080/24740527.2019.1615370. eCollection 2019.
: Approximately half of all patients who undergo surgical repair of extremity fractures report persistent postsurgical pain (PPSP) at 1-year post-surgery. Psychological factors such as anxiety, depression, catastrophization, poor coping, high somatic complaints, and pessimism about recovery are risk factors for the development of PPSP. It is possible that interventions such as cognitive behavior therapy (CBT) that target psychological factors may reduce the incidence of PPSP in this population. : The current report reviews the role of psychological factors in the development of PPSP and discusses the rationale and protocol development for a multi-site randomized-controlled trial investigating the effectiveness of CBT in reducing PPSP in patients with surgically treated extremity fractures.
大约一半接受四肢骨折手术修复的患者在术后1年报告有持续性术后疼痛(PPSP)。焦虑、抑郁、灾难化思维、应对能力差、高躯体症状以及对恢复的悲观态度等心理因素是PPSP发生的危险因素。针对心理因素的认知行为疗法(CBT)等干预措施有可能降低该人群中PPSP的发生率。:本报告回顾了心理因素在PPSP发生中的作用,并讨论了一项多中心随机对照试验的基本原理和方案制定,该试验旨在研究CBT在降低接受手术治疗的四肢骨折患者PPSP方面的有效性。