早期非小细胞肺癌单孔胸腔镜术后急性疼痛发展轨迹及影响因素分析<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2026.01.013

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Abstract 【Objective】 To investigate the progression of acute pain after single-aperture thoracoscopic surgery(VATS) in early non-small cell lung cancer(NSCLC), and to analyze the factors influencing the progression of acute pain. 【Methods】 A total of 171 early-stage NSCLC patients admitted to our hospital from July 2021 to November 2023 were selected, all of whom underwent uniportal VATS. Postoperative pain was assessed using the Numerical Rating Scale(NRS) within 1 to 7 days after surgery. The Group-Based Trajectory Model(GBTM) was employed to describe the development trajectory of acute postoperative pain in early-stage NSCLC patients undergoing uniportal VATS, categorized into Group A(n=61, mild to moderate pain significantly alleviated), Group B(n=81, moderate to severe pain gradually alleviated), and Group C(n=29, persistent high pain). A multifactorial logistic regression model was used to analyze the influencing factors of postoperative acute pain trajectory types. 【Results】 Over time, NRS scores gradually decreased in Groups A, B, and C(P<0.05), with Group C showing significantly higher NRS scores than Groups A and B(P<0.05). Statistically significant differences were observed among Groups A, B, and C in terms of operative time, body mass index, age, incision rib gap width, patient-controlled intravenous analgesia(PCIA) postoperatively, drainage tube retention time, the proportion of patients with ≥2 drainage tubes, preoperative Hospital Depression Scale(HDS) scores, preoperative Hospital Anxiety Scale(HAS) scores, and preoperative Pain Catastrophizing Scale(PCS) scores(P<0.05). Group C exhibited higher operative time, body mass index, age, postoperative PCIA proportion, drainage tube retention time, proportion of patients with ≥2 drainage tubes, preoperative HDS scores, preoperative HAS scores, and preoperative PCS scores compared to Groups A and B(P<0.05). Multivariate logistic regression analysis identified incision rib gap width, drainage tube retention time, preoperative HDS scores, operative time, and postoperative analgesic regimen as influencing factors of acute postoperative pain trajectory types in early-stage NSCLC patients undergoing uniportal VATS(P<0.05). 【Conclusion】 Patients with early NSCLC present heterogeneous acute pain development trajectory after single-aperture thoracoscopic surgery. Clinical attention should be paid to patients with narrow incisional costal space width, longer retention time of drainage tube, higher preoperative PCS score, longer operation time, and postoperative intravenous self-controlled pump, whose appropriate intervention measures should be adopted.

Key words： Carcinoma, Non-Small-Cell Lung Thoracoscopy Pneumonectomy Pain, Postoperative Root Cause Analysis

Received: 09 May 2024

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R734.2

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	Articles by authors
	QIAN Shiguo¹
	TANG Jie²
	LIU Haiming²
	WANG Shan²

Cite this article:

QIAN Shiguo¹,TANG Jie²,LIU Haiming², et al. Analysis of the Development Trajectory and Influencing Factors of Acute Pain after Single-Aperture Thoracoscopic Surgery in Early Non-Small Cell Lung Cancer Patients[J]. JOURNAL OF CLINICAL RESEARCH, 2026, 43(1): 47-51.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2026.01.013 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2026/V43/I1/47

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