| 朱慧新,戴丽群,黄秀芬,郭婧雅,方善鸿.术后疼痛对膝关节盘状半月板损伤患者膝关节功能、生活质量及心理状态的影响及其危险因素的Logistic回归分析[J].,2023,(8):1487-1492 |
| 术后疼痛对膝关节盘状半月板损伤患者膝关节功能、生活质量及心理状态的影响及其危险因素的Logistic回归分析 |
| Effect of Postoperative Pain on Knee Function, Quality of Life and Psychological Status of Patients with Discoid Meniscus Injury of Knee Joint and Logistic Regression Analysis of its Risk Factors |
| 投稿时间：2022-09-28 修订日期：2022-10-24 |
| DOI：10.13241/j.cnki.pmb.2023.08.017 |
| 中文关键词: 术后疼痛 膝关节 盘状半月板损伤 膝关节功能 生活质量 心理状态 危险因素 |
| 英文关键词: Postoperative pain Knee joint Discoid meniscus injury Knee function Quality of life Psychological state Risk factors |
| 基金项目:福建省自然科学基金面上项目（2020J01964） |
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| 中文摘要: |
| 摘要 目的：探讨术后疼痛对膝关节盘状半月板损伤患者膝关节功能、生活质量及心理状态的影响及其危险因素的Logistic回归分析。方法：选取2019年5月～2022年1月福建医科大学附属第一医院收治的膝关节盘状半月板损伤患者120例，均行关节镜手术治疗，观察并评价所有患者手术疗效；根据术后6个月膝关节是否疼痛分为疼痛组（n=16）与无痛组（n=104）。比较两组术前及术后6个月Lysholm膝关节功能评分、健康调查简表（SF-36）评分、焦虑自评量表（SAS）和抑郁自评量表（SDS）评分。单因素及多因素Logistic回归分析术后疼痛的危险因素。结果：120例膝关节盘状半月板损伤患者术前、术后3个月、术后6个月Lysholm评分分别为（56.97±8.62）分、（78.09±10.53）分、（89.26±8.14）分，术后3个月、术后6个月Lysholm评分均显著高于术前（均P＜0.001）。临床疗效显示行关节镜手术后优良率为86.67%（104/120）。术后6个月两组Lysholm评分、SF-36评分均高于手术前，但疼痛组低于无痛组（P＜0.05）；术后6个月两组SAS评分、SDS评分均低于手术前，但疼痛组高于无痛组（P＜0.05）。单因素分析发现，年龄、BMI、撕裂类型、滑膜切除、术后冷敷、开始负重时间与术后痛疼有关（P＜0.05）；而性别、受教育程度、吸烟史、饮酒史、ASA分级、患侧、病程、损伤部位、手术方式与术后痛疼无关（P＞0.05）。多因素Logistic回归分析显示，年龄、BMI≥24 kg/m2、纵裂或其他撕裂、滑膜切除、开始负重时间＜4周及术后6个月SAS评分、SDS评分是术后疼痛的独立危险因素，而术后冷敷是术后疼痛的保护因素（P＜0.05）。结论：术后疼痛对膝关节盘状半月板损伤患者膝关节功能、生活质量及心理状态产生明显负面影响。年龄、BMI≥24 kg/m2、混合性撕裂、滑膜切除、开始负重时间＜4周以及术后6个月SAS评分、SDS评分是术后疼痛危险因素，而术后冷敷是其保护因素，临床可据此施以针对性防治措施。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of postoperative pain on knee function, quality of life and psychological state in patients with discoid meniscus injury of knee joint and Logistic regression analysis of its risk factors. Methods: A total of 120 patients with discoid meniscus injury of knee joint who were treated in The First Affiliated Hospital of Fujian Medical University from May 2019 to January 2022 were selected, all of them underwent arthroscopic surgery, and the surgical efficacy of all patients was observed and evaluated. The patients were divided into pain group(n=16) and painless group(n=104) according to whether the knee joint was painful 6 months after operation. The Lysholm knee function score, Short Form Health Survey(SF-36) score, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were compared between the two groups before and 6 months after surgery. The risk factors of postoperative pain were analyzed by univariate and multivariate logistic regression. Results: The Lysholm scores of 120 patients with discoid meniscus injury of knee joint were (56.97±8.62) points, (78.09±10.53) points and (89.26±8.14) points before operation,3 months and 6 months after operation, respectively. The Lysholm scores of 3 months and 6 months after operation were significantly higher than those before operation (all P<0.001). The clinical efficacy showed that the excellent and good rate after arthroscopic surgery was 86.67% (104/120). Lysholm score and SF-36 score in 6 months after operation were higher than those before operation between two groups, but those in pain group were lower than those in painless group (P<0.05); SAS score and SDS score 6 months after operation of the two groups were lower than those before operation, but those in pain group were higher than those in painless group (P<0.05). Univariate analysis showed that age, BMI, tear type, synovial resection, postoperative cold compress and time to start weight-bearing were related to postoperative pain(P<0.05). However, gender, education degree, smoking history, drinking history, ASA grade, injured side, course of disease, injury site, and operation method were not related to postoperative pain (P>0.05). Multivariate Logistic regression analysis showed that age, BMI≥24 kg/m2, longitudinal tear or others,synovial resection, time to start weight-bearing<4 weeks, and SAS score and SDS score 6 months after operation were independent risk factors for postoperative pain, while postoperative cold compress was a protective factor for postoperative pain(P<0.05). Conclusion: Postoperative pain has a significant negative impact on knee function, quality of life and psychological status of patients with discoid meniscus injury of knee joint. Age, BMI≥24 kg/m2, mixed tear, synovial resection, time to start weight-bearing<4 weeks, and SAS score and SDS score 6 months after operation are the risk factors of postoperative pain, while postoperative cold compress is the protective factor, and clinical prevention and treatment measures can be taken accordingly. |
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