慢性术后疼痛增加了痴呆症的风险
Mingyang Sun1, Xiaolin Wang1,2, Zhongyuan Lu1,2
1Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
European journal of pain (London, England)
|February 21, 2025
概括
慢性术后疼痛 (CPSP) 显著增加痴呆症的风险. 手术后有效的疼痛管理可以降低这种风险,突出了针对性干预的必要性.
科学领域:
- 医学研究 医学研究
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 慢性术后疼痛 (CPSP) 是手术后的一个常见并发症.
- CPSP与长期认知衰退,特别是痴呆症之间的联系仍未得到充分研究.
- 了解这种关联对患者护理和公共卫生策略有重大影响.
研究的目的:
- 调查慢性术后疼痛 (CPSP) 与随后发展痴呆症的风险之间的关联.
- 解决关于持续的术后疼痛的长期神经后果的文献上的空白.
- 为临床实践和公共卫生倡议提供有关疼痛管理和认知健康的信息.
主要方法:
- 一项使用台湾国家医疗保险研究数据库的倾向分数匹配队列研究.
- 包括2004年至2018年期间接受重大手术的142,682名患者.
- 基于长期使用止痛药和追踪痴呆症诊断的CPSP定义,直到2022年12月,使用多变量Cox回归分析.
主要成果:
- 在CPSP队列中,在倾向性得分匹配之前和之后,痴呆的风险显著增加 (aHR分别为1.35和1.31).
- CPSP与痴呆风险增加之间的关联在各种人口和临床子组中是一致的.
- 敏感性分析证实了这些发现的稳定性,确定CPSP作为痴呆症的独立预测因子.
结论:
- 慢性术后疼痛是痴呆风险的独立预测因素.
- 有效的CPSP管理提供了一个机会,可以减少大约30%的痴呆风险.
- 针对CPSP的有针对性的干预措施对于缓解长期认知衰退和改善患者结果至关重要.
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