首次全髋关节置换术患者术后疼痛的相关影响因素分析

doi:10.3969/j.issn.1671-7171.2021.08.020

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摘要【目的】探讨影响首次全髋关节置换术患者术后疼痛的相关因素。【方法】回顾性分析本院骨科2016年3月至2019年4月收治的114例首次行全髋关节置换术患者的临床资料。术后随访2周,根据术后疼痛视觉模拟评分(VAS)将患者分为中重度疼痛组(VAS≥4分,观察组)及轻度疼痛组(VAS≤3分,对照组)。观察可能影响患者术后疼痛的相关因素,并对其进行单因素分析和二分类Logistic回归分析。【结果】术后随访发现,114例患者中有23例在术后2周内出现髋关节疼痛,其发生率为20.18%;观察组患者年龄、术后白细胞(WBC)、C反应蛋白(CRP)、VAS评分均高于对照组,术后功能锻炼时间短于对照组(P<0.05);随着焦虑程度的增加,疼痛发生率呈上升趋势(P<0.05);多因素Logistic回归分析显示:术后功能锻炼时间短、双下肢长度差过大、术后WBC、CRP升高均为首次全髋关节置换术后疼痛的独立危险因素(OR=3.08、3.52、3.90、3.89,P<0.05)。【结论】首次全髋关节置换术患者术后疼痛受多种因素共同影响,术后锻炼时间短、双下肢长度差过大、术后WBC和CRP水平升高均为首次全髋关节置换术后疼痛的独立危险因素,临床上应根据患者差异制定合理的手术方式,并尽可能避免危险因素的发生。

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	叶丽丽
	姜肖肖

关键词 ：关节成形术,置换,髋, 疼痛, 手术后, 危险因素

Abstract：【Objective】To explore the related factors affecting postoperative pain in patients undergoing primary total hip arthroplasty. 【Methods】The clinical data of 114 patients who underwent total hip arthroplasty from March 2016 to April 2019 were analyzed retrospectively. The patients were followed up for 2 weeks. According to the postoperative pain visual analog score (VAS), the patients were divided into moderate and severe pain group (VAS ≥ 4, observation group) and mild pain group (VAS ≤ 3, control group). The related factors that may affect postoperative pain were observed, and univariate analysis and binary logistic regression analysis were carried out. 【Results】 The postoperative follow-up showed that 23 of 114 patients had hip pain within 2 weeks after operation, and the incidence was 20.18%; The age, postoperative leukocyte (WBC), C-reactive protein (CRP) and VAS scores of the observation group were higher than those of the control group; The postoperative functional exercise time was shorter than that in the control group (P<0.05); The incidence of pain increased with the increase of anxiety (P<0.05); Multivariate logistic regression analysis showed that short postoperative functional exercise time, large length difference of both lower limbs, and increase of WBC and CRP were independent risk factors for pain after hip arthroplasty (OR=3.08, 3.52, 3.90, 3.89;P<0.05). 【Conclusion】The postoperative pain of patients undergoing total hip arthroplasty is affected by many factors. Short postoperative exercise time, large difference in the length of both lower limbs, and elevated levels of WBC and CRP were independent risk factors for pain after hip arthroplasty. Clinically, we should formulate reasonable operation methods according to the differences of patients, and avoid the occurrence of risk factors as far as possible.

Key words： Arthroplasty, Replacement, Hip Pain, Postoperative Risk Factors

收稿日期: 2021-03-08

中图分类号:

R684.75

引用本文:

叶丽丽, 姜肖肖. 首次全髋关节置换术患者术后疼痛的相关影响因素分析[J]. 医学临床研究, 2021, 38(8): 1187-1190.
YE Li-li, JIANG Xiao-xiao. Analysis of Related Factors of Postoperative Pain in Patients Undergoing Primary Total Hip Arthroplasty. JOURNAL OF CLINICAL RESEARCH, 2021, 38(8): 1187-1190.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.08.020 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I8/1187

[1] 汤澜, 叶陈毅, 陆锦炜, 等. 部分旷置二期翻修治疗全髋关节置换术后假体周围感染的早期疗效[J].中华骨科杂志, 2019, 39(7):422-428.
[2] 邓波, 王静成, 熊传芝, 等. 初次全髋关节置换术治疗老年股骨颈骨折的近期疗效及影响因素分析[J].中华创伤骨科杂志, 2016, 18(11):994-997.
[3] 包良笑, 肖军, 李涛, 等. 不同助行方式对人工全髋关节置换术后患者假体早期稳定性的影响[J].中华护理杂志, 2016, 51(6):655-658.
[4] 廖乐明, 蔡迅梓, 吴浩波, 等. 手术治疗全髋关节置换术后Vancouver B1型股骨假体周围骨折[J].中华骨科杂志, 2017, 37(15):936-941.
[5] 李薇, 宋雪. 不同助行方式对人工全髋关节置换患者术后假体早期稳定性的影响[J].中华现代护理杂志, 2017, 23(3):386-388.
[6] 曾德亮, 章放香, 余相地,等. 不同浓度右美托咪定混合罗哌卡因连续腰丛神经阻滞用于老年患者髋关节置换术后镇痛效果的比较[J].中华麻醉学杂志, 2017, 37(1):84-87.
[7] 蔡宇, 周华军, 程文俊, 等. 加速康复外科联合标准化康复路径在全髋关节置换术治疗老年股骨颈骨折患者中的应用[J].中华创伤骨科杂志, 2016, 18(8):673-678.
[8] JAUREGUI, J J, KIM, J K, SHIELD, W P,et al. Hip fusion takedown to a total hip arthroplasty—is it worth it? A systematic review[J].Int Orthop,2017,14(8):1535-1542.
[9] 张玉良, 吴宏飞, 王斌, 等. 骨水泥型与生物型假体在高龄患者全髋关节置换后早期疗效对比[J].中华老年医学杂志, 2016, 35(6):622-625.
[10] 沈松坡, 翁习生, 冯宾. 全膝关节置换术后疼痛原因分析及疼痛预测模型的研究进展[J].中华骨科杂志, 2018, 38(17):1082-1088.
[11] 董汉青, 徐耀增, 耿得春, 等. 骨小梁金属髋臼杯在全髋关节置换术中的应用及近期疗效[J].中国骨与关节损伤杂志, 2016, 31(6):571-573.
[12] 严美娟,楼小侃, 吴佳,等. 老年人髋关节置换术后硬膜外吗啡和腰骶丛神经阻滞镇痛效果比较[J].中华老年医学杂志, 2016, 35(6):634-639.
[13] UMEHARA N,MITANI S, NAMBA Y . Factors influencing health-related quality of life after total hip arthroplasty[J].Acta Med Okayama,2016, 70(2):89-96.
[14] 赵旻暐, 田华, 王宁, 等. 膝关节置换术后超声引导收肌管阻滞的镇痛疗效观察[J].中华医学杂志, 2016, 96(35):2813-2817.
[15] 石钊, 张素品, 王国林, 等. 收肌管阻滞联合闭孔神经后支阻滞用于全膝关节置换术老年病人术后镇痛的效果[J].中华麻醉学杂志, 2017, 37(11):1365-1367.
[16] 毛世刚, 张梅莹, 于观潇, 等. 全膝关节置换术患者术后早期屈曲活动度对远期活动度的影响[J].中华保健医学杂志, 2016,17(5):395-397.
[17] 邓波, 王静成, 熊传芝, 等. 初次全髋关节置换术治疗老年股骨颈骨折的近期疗效及影响因素分析[J].中华创伤骨科杂志, 2016, 18(11):994-997.
[18] MEERMANS G, KONAN S, DAS R, et al.The direct anterior approach in total hip arthroplasty: a systematic review of the literature[J].Bone Joint J,2017,99(6):732-741.
[19] 黄志宇, 张志奇, 傅明,等. 髋臼假体上移放置对髋关节发育不良全髋关节置换术后下肢长度及功能的影响[J].中华骨科杂志, 2014, 34(12):1225-1230.
[20] 赵良军, 劳山, 赵劲民,等. 局部应用氨甲环酸对全髋关节置换术围手术期隐性失血的影响[J].中华创伤骨科杂志, 2016, 18(11):945-949.