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cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究

肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心回顧性研究
貴州醫科大學 麻醉與心臟電生理課題組
翻譯：安麗 編輯：潘志軍 審校：曹瑩
1 背景
目前尚無關于胸部術后長期慢性疼痛(CPSP)發生率的報道。
2 方法
我們回顧分析了2007年至2016年間4218例因肺癌接受胸部手術患者的電子病歷。我們在36個月內每隔3個月評估一次胸部手術后CPSP的發生情況。采用Cox比例風險回歸分析探討胸部手術后CPSP的預測因素。
3 結果
共有3200名患者被納入分析。其中459例（14.3%）和558例（17.4%）患者在術后3個月和36個月內被診斷為CPSP。隨著時間的推移，CPSP的發生率降低。此外，99例(3.1%)患者在術后至少6個月被新診斷為CPSP。女性患者(風險比1.20, 95%可信區間1.00 -1.43;p=0.04)，手術時間較長的患者（風險比1.11，95%可信區間1.03-1.20；p<0.01），術后第一次門診就診時數值評定量表評分為11分較高的患者（風險比 1.29，95% 可信區間 1.24-1.34；p<0.001），術后化療的患者（風險比 1.55,95% 可信區間1.26-1.90；p<0.001），術后放射治療的患者（風險比1.35,95% 可信區間1.05-1.74；p=0.02），上述均為術后36個月CPSP的顯著預測因子。
【 cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究】
cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究
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cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究
文章插圖


cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究
文章插圖


cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究
文章插圖


cpsp|【罌粟摘要】肺癌術后長期慢性疼痛的發生率情況：一項為期十年的單中心?回顧性研究
文章插圖

4 結論
我們的研究顯示胸外科術后CPSP的發生率以及延遲發作或復發有降低的趨勢，能更好地了解胸部術后CPSP的進展，可為其預測和治療提供重要信息。
原始文獻來源 ?
Susie Yoon, Won-Pyo Hong, Hyundeok Joo, Hansol Kim, Samina Park,Jae-Hyon Bahk,Ho-Jin Lee.Long-term incidence of chronic postsurgical pain after thoracic surgery for lung cancer: a 10-year single-center retrospective study.Reg Anesth Pain Med 2020 05;45(5).DOI：10.1136/rapm-2020-101292.
英文原文
Long-term incidence of chronic postsurgical pain after thoracic surgery for lung cancer: a 10-year single-center retrospective study
Abstract
Background:The long-term incidence of chronic postsurgical pain (CPSP) after thoracic surgery has not yet been reported.
Methods:We retrospectively reviewed the electronic medical records of 4218 consecutive patients who underwent thoracic surgery for lung cancer between 2007 and 2016. We evaluated the long-term incidence of CPSP after thoracic surgery at intervals of 3 months for 36 months. A Cox proportional hazard regression analysis was performed to investigate the predictors of CPSP after thoracic surgery.
Result:A total of 3200 patients were included in the analysis. Of these, 459 (14.3%) and 558 (17.4%) patients were diagnosed with CPSP within 3 and 36 months after surgery, respectively. Furthermore, the incidence of CPSP decreased over time. Additionally, 99 (3.1%) patients were newly diagnosed with CPSP at least 6 months after surgery. Female sex (HR 1.20, 95% CI 1.00 to 1.43; p=0.04), longer duration of surgery (HR 1.11, 95% CI 1.03 to 1.20; p<0.01), higher 11-point Numeric Rating Scale score at first outpatient visit after surgery (HR 1.29, 95% CI 1.24 to 1.34; p<0.001), postoperative chemotherapy (HR 1.55, 95% CI 1.26 to 1.90; p<0.001), and postoperative radiation therapy (HR 1.35, 95% CI 1.05 to 1.74; p=0.02) were significant predictors of CPSP for 36 months after surgery.