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在全关节整形术中术后疼痛轨迹

Kareem Omran¹, Daniel Waren², Ran Schwarzkopf²

¹Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Bone & joint open

|March 5, 2024

概括

这项研究在全关节整形术 (THA) 后确定了三种不同的疼痛轨迹. 某些患者特征,包括种族和BMI,与较差的疼痛恢复有关,突出了个性化手术前护理的需要.

科学领域:

整形外科手术整形外科手术
疼痛管理疼痛管理
患者的治疗结果.

背景情况:

全关节整形术 (THA) 是关节骨关节炎的常见手术.
在THA之后的术后恢复显示出显著的患者变异性.
了解疼痛轨迹对于改善患者治疗结果至关重要.

研究的目的:

在THA之后识别不同的疼痛轨迹.
为了确定与低最佳疼痛恢复相关的患者特征.
为改善术后疼痛管理提供有针对性的干预信息.

主要方法:

对1249名THA患者进行了回顾性队列研究.
利用患者报告结果测量信息系统 (PROMIS) 的疼痛强度数据.
采用生长混合模型 (GMM) 来分析特征关联的疼痛轨迹和多项式逻辑回归.

主要成果:

确定了三种不同的疼痛轨迹:快速恢复 (91.6%),持续的手术前疼痛 (4.5%) 和持续的长期疼痛 (3.9%).
非洲裔美国人更有可能经历低于最佳的疼痛轨迹.
更高的BMI,更长的术后停留,以及退院康复预测持续的长期疼痛.

结论:

在THA之后存在不同的疼痛轨迹,受患者个体因素的影响.
术前识别和管理风险因素对于优化康复至关重要.
针对有风险人群的有针对性的干预措施可以减轻低于最佳的疼痛结果.

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