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关节镜半月板切除术术后负性疼痛思维问卷短式量表(NPTQ-SF)评分与结局

Negative Pain Thoughts Questionnaire Short Form (NPTQ-SF) Scores and Outcomes After Arthroscopic Meniscectomy.

机构信息

Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA.

出版信息

Am J Sports Med. 2024 Sep;52(11):2770-2774. doi: 10.1177/03635465241265321. Epub 2024 Aug 23.

Abstract

BACKGROUND

Pain is multifactorial, and pain intensity has been shown to be influenced by patients' thoughts. The Negative Pain Thoughts Questionnaire Short Form (NPTQ-SF) can be used to quantify unhelpful negative cognitive biases about pain, but the relationship between negative pain thoughts and orthopaedic surgery outcomes is not known.

PURPOSE

To evaluate the prevalence of negative pain thoughts in patients undergoing arthroscopic meniscectomy using the NPTQ-SF survey and assess the relationship these thoughts have to knee function, general health, pain, and satisfaction before and after surgery.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

In total, 146 patients undergoing arthroscopic meniscectomy were administered the 4-item NPTQ-SF, 12-item Short Form Survey (SF-12), International Knee Documentation Committee (IKDC) questionnaire, and visual analog scale pain survey preoperatively between July 2021 and August 2022. The same surveys were completed at a minimum of 3 months and no later than 1 year postoperatively by 92 patients confirmed to have undergone meniscectomy.

RESULTS

NPTQ-SF scores were correlated with IKDC, SF-12, and satisfaction score preoperatively and at least 3 months postoperatively (mean, 108.5 ± 43.7 days). Preoperative NPTQ-SF scores were significantly negatively correlated with postoperative IKDC ( = -0.284), SF-12 ( = -0.266 and -0.328), and visual analog scale pain ( = 0.294) scores, while a relationship with postoperative satisfaction did not reach statistical significance ( = .067). Patients with a preoperative NPTQ-SF score >8 were less likely to achieve a Patient Acceptable Symptom State on the postoperative IKDC questionnaire (39% vs 63%; = .03). Patients with a history of a psychiatric or chronic pain diagnoses have worse NPTQ-SF, SF-12, and IKDC scores pre- and postoperatively.

CONCLUSION

The level of negative pain thoughts in patients undergoing meniscectomy is related to knee function, general health, and pain. Patients with a high level of negative pain thoughts are less likely to achieve a favorable outcome from meniscectomy, with a score ≥8 representing a clinically significant threshold for preoperative screening.

摘要

背景

疼痛是多因素的,疼痛强度已被证明受到患者思维的影响。负面疼痛思维问卷短表(NPTQ-SF)可用于量化对疼痛的无益负面认知偏差,但负面疼痛思维与骨科手术结果之间的关系尚不清楚。

目的

使用 NPTQ-SF 调查评估接受关节镜半月板切除术的患者中负面疼痛思维的发生率,并评估这些思维与膝关节功能、一般健康状况、疼痛和术前术后满意度之间的关系。

研究设计

病例系列;证据水平,4 级。

方法

2021 年 7 月至 2022 年 8 月期间,共 146 名接受关节镜半月板切除术的患者接受了 4 项 NPTQ-SF、12 项简短表格健康调查(SF-12)、国际膝关节文献委员会(IKDC)问卷和视觉模拟量表疼痛调查。92 名已确认接受半月板切除术的患者至少在术后 3 个月(平均 108.5±43.7 天)进行了相同的调查。术前 NPTQ-SF 评分与术前和至少 3 个月后的 IKDC、SF-12 和满意度评分呈正相关(平均 108.5±43.7 天)。术前 NPTQ-SF 评分与术后 IKDC( = -0.284)、SF-12( = -0.266 和-0.328)和视觉模拟量表疼痛( = 0.294)评分呈显著负相关,而与术后满意度的相关性无统计学意义( =.067)。术前 NPTQ-SF 评分>8 的患者在术后 IKDC 问卷中更不可能达到患者可接受的症状状态(39%比 63%; =.03)。有精神病史或慢性疼痛诊断的患者术前和术后的 NPTQ-SF、SF-12 和 IKDC 评分更差。

结论

接受半月板切除术的患者的负面疼痛思维程度与膝关节功能、一般健康状况和疼痛有关。高水平的负面疼痛思维的患者不太可能从半月板切除术获得良好的结果,术前筛查的评分≥8 代表了一个有临床意义的阈值。

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