摘要
目的 分析胸腰椎骨折患者术后急性疼痛发展的状况,采用潜在剖面分析术后急性疼痛的异质性,并探讨影响不同急性疼痛进展分型的相关因素。方法 选取2020年4月—2023年9月于浙江省人民医院淳安分院接受经皮穿刺椎体成形术(PVP)治疗的180例胸腰椎骨折术后患者为研究对象。采用一般资料调查表、视觉模拟疼痛评分量表对患者进行调查。对胸腰椎骨折术后患者急性疼痛进行潜在剖面分析,并通过多元有序logistic回归分析研究影响胸腰椎骨折患者术后急性疼痛的因素。结果 胸腰椎骨折术后患者急性疼痛进展得分为(6.78±1.13)分;当类别数目为3时,AIC、BIC、aBIC下降趋于平缓,LMRT的P值>0.001,故选取3个潜在剖面,分别为轻度疼痛(35.54%)、中度疼痛(43.98%)、重度疼痛(20.48%);重度疼痛患者BMI>24、骨折椎体个数>2个、骨水泥分布不满意、椎体恢复高度高、骨折部位在腰椎患者的占比显著高于轻度疼痛组和中度疼痛组(P<0.05)。多因素logistic分析显示,骨折椎体个数>2个、BMI≥24、骨水泥分布不满意、骨折部位在腰椎、椎体恢复高度高均为胸腰椎骨折术后重度疼痛的危险因素(P<0.05)。结论 胸腰椎骨折术后患者急性疼痛进展水平偏高,且存在异质性;其中骨折椎体>2个、BMI≥24、骨水泥分布不满意、骨折部位在腰椎以及椎体恢复高度高是胸腰椎骨折术后患者重度疼痛的危险因素。
Objective This study aims to analyze the progression of postoperative acute pain in patients with thoracolumbar fracture,analyze the variability in postoperative acute pain profiles,and explore factors affecting the patterns of different acute pain progression.Methods From April 2020 to September 2023,a total of 180 postoperative patients with thoracolumbar fractures underwent percutaneous vertebro plasty(PVP)in Chun'an Branch of Zhejiang Provincial People's Hospital were enrolled in this study.These patients were assessed using a general information questionnaire and a visual analogue pain scale.The study analyzed the potential profiles of acute pain after thoracolumbar fracture and identified the factors affecting acute pain through multivariate ordered logistic regression.Results The mean score of acute pain after thoracolumbar fracture operation was(6.78±1.13)points.When the number of categories is 3,the decline in AIC,BIC,and aBIC became gradual,and the P-value of LMRT exceeded 0.001,indicating that three potential profiles are appropriate:mild pain(35.54%),moderate pain(43.98%),and severe pain(20.48%).Patients with severe pain had a significantly higher proportion of BMI≥24,more than two fractured vertebral bodies,unsatisfied bone cement distribution,concurrent osteoporosis,high vertebral body recovery,and lumbar spine fracture sites compared to those in the mild pain group and moderate pain group(P<0.05).Multivariate logistic analysis showed that more than two fractured vertebral bodies,BMI≥24,unsatisfactory bone cement distribution,lumbar vertebrae fracture sites,and high vertebral body recovery were significant factors influencing severe pain after thoracolumbar fractures(P<0.05).Conclusion The level of acute pain in patients with thoracolumbar fracture after operation is high and exhibits heterogeneity.Notably,factor such as fracture vertebral bodies>2,BMI≥24,unsatisfactory body cement distribution,lumbar vertebrae fracture sites,and vertebral body recovery are significant contributors to severe pain in patients with thoracolumbar fractures after operation.
作者
郑勇红
郑明军
冯法博
ZHENG Yonghong;ZHENG Mingjun;FENG Fabo(Department of Orthopedics,Chun'an Branch of Zhejiang Provincial People's Hospital,Hangzhou,Zhejiang 311700,China;不详)
出处
《中华全科医学》
2025年第2期239-242,291,共5页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2024KY664)。
关键词
胸腰椎骨折
经皮穿刺椎体成形术
术后疼痛
发展轨迹
影响因素
Thoracolumbar fracture
Percutaneous vertebro plasty
Postoperative pain
Progression
Influencing factors
