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侧方压缩型骨盆环损伤后的疼痛感知、阿片类药物使用情况及活动能力:一项为期两年的前瞻性队列研究。

Pain perception, opioid consumption and mobility following lateral compression pelvic ring injuries: a two-year prospective cohort study.

作者信息

Therrien Camryn C, Ten Duis Kaj, de Vries Jean-Paul P M, Reininga Inge H F, IJpma Frank F A

机构信息

Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Eur J Orthop Surg Traumatol. 2025 Jan 11;35(1):55. doi: 10.1007/s00590-024-04128-w.

Abstract

PURPOSE

A prospective longitudinal cohort study was performed to gain insight into the course of recovery in terms of pain, opioid consumption, and mobility in patients with a lateral compression (LC) pelvic injury.

METHODS

Adult patients with an LC injury, without any cognitive disorders or limited mobility and who could communicate in Dutch were asked to participate. Pain in terms of NRS (numeric rating scale, range 0-10), opioid use and mobility were recorded at eight time points: at hospital admission, and three days, one week, six weeks, three months, six months, one year and two years after the injury. A sub-analysis was performed for nonoperatively and operatively treated patients.

RESULTS

Ninety-seven patients were included, of which 23 (24%) were treated operatively and 74 (76%) conservatively. Pain at rest and exertion, were highest upon admission (mean NRS of 3.4 (SD = 2.6) and 4.4 (SD = 2.8), respectively) but decreased within six weeks (mean NRS of 0.8 (SD = 1.6) and 2.0 (2.0), respectively). After two years, the mean NRS was 0.5 (SD = 1.6) and 0.9 (SD = 2.1), respectively. Upon admission, 85% were given opioids, however only 11% used opioids after three months and 4% after two years. At three months, 35% were walking using walking aids and 58% were walking independently. After two years, 98% were walking independently.

CONCLUSIONS

Pain rapidly decreased within the first six weeks. Most patients did not need opioids after three months. Furthermore, most patients were walking with walking aids after six weeks. After two years, few patients experienced pain, used opioids or had difficulties walking.

摘要

目的

开展一项前瞻性纵向队列研究,以深入了解侧方压缩(LC)骨盆损伤患者在疼痛、阿片类药物使用及活动能力方面的恢复过程。

方法

纳入成年LC损伤患者,要求其无任何认知障碍、活动能力不受限且能用荷兰语交流。在八个时间点记录患者的数字疼痛评分量表(NRS,范围0 - 10)疼痛情况、阿片类药物使用情况及活动能力,这八个时间点分别为:入院时、受伤后三天、一周、六周、三个月、六个月、一年及两年。对接受非手术治疗和手术治疗的患者进行亚组分析。

结果

共纳入97例患者,其中23例(24%)接受了手术治疗,74例(76%)接受了保守治疗。静息和活动时的疼痛在入院时最高(平均NRS分别为3.4(标准差=2.6)和4.4(标准差=2.8)),但在六周内有所下降(平均NRS分别为0.8(标准差=1.6)和2.0(2.0))。两年后,平均NRS分别为0.5(标准差=1.6)和0.9(标准差=2.1)。入院时,85%的患者使用了阿片类药物,但三个月后只有11%的患者使用阿片类药物,两年后为4%。三个月时,35%的患者借助助行器行走,58%的患者可独立行走。两年后,98%的患者可独立行走。

结论

疼痛在最初六周内迅速减轻。大多数患者在三个月后不再需要使用阿片类药物。此外,大多数患者在六周后借助助行器行走。两年后,很少有患者仍有疼痛、使用阿片类药物或行走困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95b0/11724773/64030369b693/590_2024_4128_Fig1_HTML.jpg

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