在ERAS协议下接受全膝关节关节整形手术的患者中,早期的术后疼痛及其危险因素
Liming Wu1, Shiyu Sun2, Yanpeng Kan2
1Department of Pain Medicine, The Fifth People's Hospital of Wujiang Area, Suzhou, Jiangsu, 215200, People's Republic of China.
Journal of pain research
|March 16, 2026
概括
整膝关节整形手术 (TKA) 的手术后增强恢复 (ERAS) 协议仍然看到显著的早期疼痛. 关键的风险因素包括更长的轮时间,手术前的焦虑和四头肌力量的减少,指导有针对性的干预措施以改善恢复.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 临床研究 临床研究
背景情况:
- 手术后增强恢复 (ERAS) 协议优化了全膝关节整形术 (TKA) 的术后护理.
- 尽管实施了ERAS,但TKA患者仍然存在早期术后疼痛的显著风险.
- 识别高风险因素对于制定有针对性的疼痛管理策略至关重要.
研究的目的:
- 调查ERAS管理的TKA患者中早期术后疼痛的当前发病率.
- 确定与中度至重度早期疼痛相关的关键独立风险因素.
- 促进开发有针对性的干预措施,以改善患者的康复.
主要方法:
- 对183名通过ERAS管理的TKA患者进行了回顾性分析.
- 在术后的第三天将患者分为轻度 (NRS ≤3) 和中度至重度 (NRS >3) 疼痛组.
- 单变量和多变量逻辑回归分析以确定独立的风险因素.
主要成果:
- 27.87%的TKA患者经历了中度至重度的早期术后疼痛.
- 确定了独立的风险因素:手术期间的带时间,手术前的汉密尔顿焦虑量表 (HAMA) 评分,手术前的四头骨厚度和手术前的膝关节社会评分 (KSS).
- 一个预测性名图显示出高预测值 (AUC = 0.892).
结论:
- 中度至重度的早期疼痛在接受ERAS的TKA患者中普遍存在.
- 疼痛独立地与更长的带时间,更高的手术前焦虑,更薄的四头肌和较低的KSS有关.
- 这些已识别的因素使得早期预测和有针对性的干预措施能够促进恢复.
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