结直肠手术后疼痛预测结果:前性队列研究
Joao Victor de Cerqueira1,2,3, Francesca Fermi1,2,3, Samin Shirzadi2,3
1Department of Surgery, McGill University, Montreal, QC, Canada.
Surgical endoscopy
|September 2, 2025
概括
大肠直肠手术后的退院疼痛通常是积极的,但受患者的因素影响,如慢性疼痛,焦虑和抑郁,以及当天退院等护理因素. 了解这些因素可以优化疼痛管理策略.
科学领域:
- 大肠直肠手术
- 治疗疼痛
- 患者的结果
背景情况:
- 结直肠手术后的疼痛管理由于其复杂性和潜在的不良事件而带来挑战.
- 确定可修改的因素对于优化患者护理和改善疼痛结果至关重要.
- 这项研究研究了影响大肠直肠手术后7天后疼痛的患者和护理相关因素.
研究的目的:
- 评估人口,临床,情绪和护理相关因素对退院后疼痛强度,疼痛干扰和对疼痛管理的满意度的影响.
- 在接受结直肠手术的患者中确定疼痛结果的关键预测因素.
- 为改善疼痛管理和患者体验制定有针对性的策略.
主要方法:
- 在加拿大两所大学附属医院进行选择性结肠直肠手术的347名成年患者的队列研究.
- 收集的手术前数据包括人口统计,疼痛灾难化量表和PROMIS-29焦虑和抑郁量表.
- 贝叶斯模型平均值用于评估预测因素和7天后疼痛结果 (疼痛强度,疼痛干扰,满意度) 之间的关联.
主要成果:
- 观察到总体上是积极的退院后疼痛结果,疼痛强度中位数为3/10,38%的人表示满意度较低.
- 慢性疼痛与更高的疼痛强度和更低的满意度有关.
- 增加的疼痛干扰与年轻的年龄,同日出血,焦虑,疼痛灾难性和女性性别有关. 抑郁症预测满意度较低,而TAP阻断使用与满意度更高相关.
结论:
- 大肠直肠手术后的疼痛结果受到人口,临床,情绪和护理相关因素的组合的影响.
- 这些发现突显出需要多方面的策略来解决这一患者群体的疼痛管理复杂性.
- 这项研究为改善患者体验和优化结直肠手术后的疼痛管理方案提供了宝贵的见解.
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