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在关节置换手术后发展慢性术后疼痛的生物心理社会预测因素:系统性审查

Rachel J H Smits¹, Rosa Poppen¹, Jetze Visser²

¹Department of Anesthesiology, Pain- and Palliative Medicine, Radboudumc, 6500 HB, Nijmegen, the Netherlands.

Osteoarthritis and cartilage open

|January 6, 2026

概括

慢性疼痛影响到14%的关节整形患者. 生物心理社会因素,如BMI,手术前疼痛和心理健康预测这种风险,帮助个性化治疗策略.

科学领域:

整形外科整形外科整形外科
疼痛医学医学疼痛医学
系统审查是系统的审查.

背景情况:

全关节整形术 (THA) 是治疗末期关节炎的常见手术.
很大一部分患者 (14%) 在THA.感染一年后出现慢性术后疼痛 (CPSP).
CPSP的病因是多因素的,需要确定预测因素.

研究的目的:

系统地审查最近关于THA后CPSP预测因素的文献.
为开发一种预后模型提供信息,以便更好地识别患者和术后管理.
确定针对性干预的可修改风险因素.

主要方法:

在PubMed,EMBASE和CENTRAL的系统文献搜索到2025年6月16日.
纳入标准:患者>18岁,报告生物心理社会风险因素和疼痛>手术后3个月.
包含的研究的质量和偏差评估风险.

主要成果:

十五项研究符合纳入标准.
鉴定的生物心理社会因素包括:BMI,手术前疼痛,并发症,功能障碍,吸烟,非白人种族,睡眠障碍,抑郁症状,焦虑,中央敏感化和疼痛灾难化.
年龄 (年轻) 和女性性别也与风险增加有关;一些因素显示出不一致的关联.

结论:

确定可修改的风险因素可以指导预康复和优化策略.
个性化多模式止痛可能有利于高风险患者.
知情同意应包括讨论CPSP风险;对于高风险个人,可以考虑非手术选择.

关键词:

麻醉学麻醉学慢性疼痛是一种慢性疼痛.慢性术后疼痛慢性术后疼痛康复预先治疗康复前治疗整体关节整形术关节整形术

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