在选择性微创性结直肠手术后,急性术后疼痛增加的预测因素
Mario Kaufmann1, Vanessa Orth1, Tim-Janick Dorwarth1
1Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
International journal of colorectal disease
|March 11, 2026
概括
在微创肠道手术后,严重的术后疼痛的预测因素包括年轻的年龄和更高的贝克抑郁指数 (BDI) 分数. 识别这些因素有助于优化疼痛管理策略,以改善手术后恢复 (ERAS).
科学领域:
- 外科手术 手术手术
- 疼痛管理 疼痛管理
- 精神病学是一个精神病学.
背景情况:
- 手术后的急性疼痛阻碍了手术后增强的恢复 (ERAS) 协议.
- 多模式疼痛管理策略并不总是足以缓解某些患者的严重疼痛.
- 识别严重疼痛的预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定选择性微创肠道手术后严重术后疼痛的预测因素.
- 分析影响疼痛水平的术前和术后特征.
- 以告知有针对性的疼痛管理干预措施.
主要方法:
- 从49名接受肠切除的患者 (2021年4月至2022年3月) 的数据分析.
- 对手术前和手术内变量的单变量和多变量分析.
- 术后严重疼痛的定义是数值评分表 (NRS) 在休息状态下 ≥4的得分.
主要成果:
- 在术后第一天 (POD1),患有严重疼痛的患者的贝克抑郁指数 (BDI) 得分显著更高 (16.1比8.89,p=0.007).
- 在多变量分析中,BDI得分仍然是一个重要的预测指标 (OR 1.14,p=0.002).
- 在POD2中,年轻的患者经历的疼痛明显增加 (53.1 vs. 65.8年,p=0.01),多变量分析证实 (OR 1.12,p=0.019).
结论:
- 年龄较小和BDI得分较高是严重术后疼痛的重要预测因素.
- 炎症性肠病 (IBD) 也被确定为一个预测因素.
- 这些发现可以指导手术患者的个性化疼痛管理.
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