肺癌手术后的慢性胸腔切除术后疼痛:对手术前风险因素的前性研究
Allan Vestergaard Danielsen1,2, Jan Jesper Andreasen1,2, Birthe Dinesen3
1Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Scandinavian journal of pain
|June 16, 2023
概括
手术前的焦虑和抑郁,以及神经病痛症状,增加了患肺癌手术后慢性胸切除术后疼痛的风险. 早期识别可以指导预防策略.
科学领域:
- 疼痛医学 医学 疼痛医学
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
背景情况:
- 慢性胸切除术后疼痛 (CPTP) 是肺癌手术后的一个重大问题.
- 手术前的心理因素和疼痛机制可能会影响CPTP的发展.
- 了解这些风险因素对于制定有效的疼痛管理策略至关重要.
研究的目的:
- 调查手术前疼痛机制,焦虑和抑郁以及患CPTP的风险之间的联系.
- 在接受肺癌手术的患者中确定CPTP的预测因素.
主要方法:
- 一项纵向队列研究,涉及121名接受视频辅助胸腔镜手术或肺癌前胸切除术的患者.
- 术前评估包括定量感官测试 (QST),神经病痛症状清单 (NPSI) 和医院焦虑和抑郁量表 (HADS).
- 在手术后六个月,CPTP使用数值评分表进行了评估.
主要成果:
- 46.3%的患者在六个月后报告了CPTP.
- 更高的手术前HADS得分 (p=0.025),NPSI得分 (p=0.009) 和急性术后疼痛 (p=0.042) 与CPTP的发展有关.
- 在手术前的QST评估或HADS子得分中没有发现显著差异.
结论:
- 术前焦虑,抑郁,神经病痛症状和急性术后疼痛与肺癌手术后的CPTP有关.
- 在手术前的QST评估中,预测CPTP没有显著差异.
- 在手术前确定高风险患者可以促进个性化的预防措施和疼痛管理.
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
01:27Pneumothorax-II
218
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
218
01:23Peripheral Artery Disease V: Postoperative Nursing Management
13
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
13
01:22Chronic Obstructive Pulmonary Disease
1.3K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.3K
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
237
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
237
01:22Aneurysm IV: Nursing Management
11
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
11