分析脊髓损伤患者神经性疼痛相关影响因素:一项回顾性研究。
Analysis of the influencing factors related to neuropathic pain in patients with spinal cord injuries: a retrospective study.
机构信息
Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China.
School of Clinical Medicine, Guizhou Medical University Guiyang, Guiyang, PR China.
出版信息
Br J Neurosurg. 2023 Dec;37(6):1588-1593. doi: 10.1080/02688697.2022.2043242. Epub 2022 Feb 24.
BACKGROUND
The aim of this study was to investigate the related influencing factors of neuropathic pain (NP) in patients with spinal cord injury (SCI).
METHODS
Patients diagnosed with SCI between January 2016 and December 2019 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University, were screened for NP by using the Douleur Neuropathique 4 (DN4) questionnaire. A total of 133 patients diagnosed with SCI with NP were finally included in the study. We collected the patients' basic information, including gender, age, body mass index (BMI), disease course, injury segment, American Spinal Injury Association (ASIA) grade, occupation, educational level, whether painkillers were used, stability of economic support, and pain level. Univariate and multiple ordered logistic regression analyses were used to examine the influencing factors of NP in the patients with SCI.
RESULTS
The chi-square test revealed that disease course, injury level, severity of SCI (ASIA classification), stable economic support during hospitalization, and the use of painkillers had statistical significance ( < .01). A multivariate logistic regression analysis was performed to analyze the influencing factors of NP. ASIA grade, stable economic support, and use of painkillers were independent influencing factors of NP in patients with SCI, among which injury severity was the independent risk factor (odds ratio [OR] > 1). Stable economic support and painkiller use were protective factors (OR < 1).
CONCLUSIONS
In this study, we found no significant correlation between NP after SCI and sex, age, BMI, disease course, injury level, and occupation. However, the injury severity was an independent risk factor, and stable economic support and painkiller use were protective factors.
背景
本研究旨在探讨脊髓损伤(SCI)患者神经病理性疼痛(NP)的相关影响因素。
方法
2016 年 1 月至 2019 年 12 月,在贵州医科大学附属医院康复医学科筛选出 NP 患者,采用 Douleur Neuropathique 4(DN4)问卷进行评估,最终纳入 133 例 SCI 合并 NP 患者。收集患者的基本信息,包括性别、年龄、体质指数(BMI)、病程、损伤节段、美国脊髓损伤协会(ASIA)分级、职业、受教育程度、是否使用止痛药、经济支持稳定性、疼痛程度。采用单因素和多因素有序逻辑回归分析探讨 SCI 患者 NP 的影响因素。
结果
卡方检验显示病程、损伤节段、SCI 严重程度(ASIA 分级)、住院期间经济支持稳定、使用止痛药有统计学意义( < .01)。对 NP 的影响因素进行多因素逻辑回归分析。ASIA 分级、经济支持稳定和使用止痛药是 SCI 患者 NP 的独立影响因素,其中损伤严重程度是 NP 的独立危险因素(比值比 [OR] > 1),经济支持稳定和使用止痛药是保护因素(OR < 1)。
结论
本研究发现,SCI 后 NP 与性别、年龄、BMI、病程、损伤节段和职业无关。然而,损伤严重程度是独立的危险因素,经济支持稳定和使用止痛药是保护因素。