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术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析

道日敖,  田园,  陈焕,  张越伦,  于春华

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道日敖, 田园, 陈焕, 张越伦, 于春华. 术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0580
引用本文: 道日敖, 田园, 陈焕, 张越伦, 于春华. 术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0580
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DAO Riao, TIAN Yuan, CHEN Huan, ZHANG Yuelun, YU Chunhua. Incidence and Influencing Factors of Subacute and Chronic Pain in Patients Returning to ICU After Surgery[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0580
Citation: DAO Riao, TIAN Yuan, CHEN Huan, ZHANG Yuelun, YU Chunhua. Incidence and Influencing Factors of Subacute and Chronic Pain in Patients Returning to ICU After Surgery[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0580
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术后返回ICU患者亚急性和慢性疼痛发生率及影响因素分析

doi: 10.12290/xhyxzz.2023-0580

  • 1 中国医学科学院北京协和医院 麻醉科, 北京 100730;

  • 2 中国医学科学院北京协和医院 重症医学科, 北京 100730;

  • 3 中国医学科学院北京协和医院 医学科学研究中心, 北京 100730

基金项目: 

中央高水平医院临床科研专项（2022-PUMCH-A-148；2022-PUMCH-B-007）；中国医学科学院医学与健康科技创新工程（2021-12M-C&T-B-020）

详细信息
    通讯作者:

    于春华,E-mail:yu.chunhua@aliyun.com

  • 中图分类号: R441.1；R614

Incidence and Influencing Factors of Subacute and Chronic Pain in Patients Returning to ICU After Surgery

  • 1 Department of Anesthesiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China;

  • 2 Department of Critical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China;

  • 3 Medical Science Research Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China

Funds: 

National High Level Hospital Clinical Research Funding（2022-PUMCH-A-148；2022-PUMCH-B-007）； the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2021-I2M-C&T-B-020)

    摘要
  • 摘要: 目的 分析术后返回ICU的患者亚急性和慢性疼痛发生率及影响因素，为临床评估及管理该类患者提供诊疗思路。 方法 前瞻性选择2021年11月29日~2021年12月31日在北京协和医院接受手术治疗后返回ICU的患者。在出院1个月和3个月后进行电话随访，评估亚急性和慢性疼痛发生率及特征，并进一步分析影响因素。 结果 共纳入术后返回ICU患者117例，平均年龄（60.9±16.0）岁，亚急性疼痛发生率为45.7%（53/116），慢性疼痛发生率为32.7%（36/110）。术后中重度亚急性疼痛和慢性疼痛数字评价量表均值分别为4.9±1.2和5.2±1.1。多因素Logistic回归分析显示，合并冠心病（OR=5.263，95% CI：1.436~19.292）是术后返回ICU患者慢性疼痛的危险因素。 结论 术后返回ICU患者的术后亚急性和慢性疼痛发生率较高，合并冠心病是慢性疼痛的危险因素。围术期采用多模式疼痛管理改善患者ICU住院期间疼痛体验以及患者短期和长期预后。
    Abstract: Objective To explore the incidence and related factors of subacute and chronic pain in patients returning to the ICU after surgery, provide diagnostic and therapeutic insights for the evaluation and management of such patients, and improve the prognosis of this population. Methods Patients who underwent surgical treatment and returned to the ICU from November 29, 2021 to December 31, 2021 at Peking Union Medical College Hospital were prospectively recruited. Subacute and chronic pain incidence and characteristics were assessed by telephone at 1 and 3 months after surgery and the influencing factors were further explored. Results A total of 117 patients were enrolled， with an average age of 60.85 ± 16.03 years. The incidence of subacute postoperative pain in patients returning to the ICU after surgery was 45.7%（53/116）， and the incidence of chronic postoperative pain in patients returning to the ICU after surgery was 32.7% （36/110） . The mean NRS for moderate to severe subacute pain and chronic pain after surgery were (4.9±1.2) and (5.2±1.1), respectively. Multivariable logistic regression analysis showed that coronary artery disease （OR=5.263 ， 95%CI ： 1.436~19.292） was risk factor for chronic postoperative pain in patients returning to the ICU after surgery. Conclusions Cardiac surgery and coronary artery disease were the risk factors for postoperative chronic pain in patients returning to the ICU, a relatively common surgical complication. Perioperative multimodal pain management can be used to improve the pain experience of patients during ICU hospitalization and the shortterm and long-term prognosis of patients.
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出版历程
  • 收稿日期:  2023-11-30
  • 录用日期:  2023-12-27
  • 网络出版日期:  2024-04-08

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