钱贞，张丽霞，朱奕，丁文，王彤.脊髓损伤患者神经病理性疼痛现况调查及相关影响因素分析[J].中华物理医学与康复杂志,2017,39(8):582-587
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| 脊髓损伤患者神经病理性疼痛现况调查及相关影响因素分析 |
| Factors influencing neuropathic pain in patients with spinal cord injury |
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| DOI： |
| 中文关键词: 脊髓损伤 神经病理性疼痛 疼痛 |
| 英文关键词: Spinal cord injury Neuropathic pain Pain |
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| 中文摘要: |
| 目的 调查脊髓损伤患者神经病理性疼痛（NP）现况，并分析其相关影响因素。 方法 先用DN4量表在所有诊断为脊髓损伤的患者中筛选出伴有NP的患者，搜集70例脊髓损伤伴NP患者的性别、年龄、文化程度、职业、平均月收入、损伤部位、婚姻状态等一般调查资料，然后再对筛选出来的患者用简化的McGill疼痛问卷表（SF-MPQ）进行NP现况调查，记录患者的疼痛目测类比法（VAS）评分以及疼痛评级指数(PRI)，包括PRI-感觉项、PRI-情感项及PEI等平均得分；采用SPSS13.0统计软件对患者的基本资料进行单因素和多因素统计分析，分析患者NP的影响因素。 结果 ①患者的平均疼痛目测类比法（VAS）评分4.37分；SF-MPQ调查的平均PRI得分8.23分，PRI-感觉项平均得分5.2 3分，PRI-情感项平均得分3.00分；现在疼痛强度(PPI)平均程度为1.86，PPI介于轻痛和难受之间，PPI中出现最多的是难受这个描述词。疼痛描述词按出现频率排在前三位的是刺痛、烧灼痛和坠胀痛。有60例（85.7%）患者认为疼痛对其情感状态造成影响，出现最多的是疲惫耗竭感这个描述词。②单因素分析显示损伤程度、文化程度、婚姻状况、家庭人均月收入、家人支持与否以及是否用药是NP的影响因素（P<0.01），而性别、年龄、病程、损伤部位、职业等因素与VAS评分无明显相关性（P>0.05）；多因素Logistic回归分析显示，未婚、损伤程度重为NP的独立保护因素（OR＜1），家庭人均月收入低、没有家人支持、没有用药为NP的独立危险因素（OR＞1）。 结论 脊髓损伤患者NP感觉多样，疼痛程度中等，绝大多数患者情感状态受到影响；未婚和损伤程度重为独立保护因素，家庭人均月收入低、没有家人支持及没有用药为其独立危险因素。 |
| 英文摘要: |
| Objective To investigate the neuropathic pain (NP) accompanying spinal cord injury (SCI), and to analyze the related factors to provide references for its prevention and treatment. Methods Seventy SCI patients with NP were selected using the DN4 scale. Their age, gender, occupation, education level, monthly income, injury position, marital status and other data were surveyed using a general questionnaire. Their NP situation was surveyed using a simplified McGill pain questionnaire (SF-MPQ). Results The patients′ average visual analogous scale (VAS) score was 4.37. Their average pain rating index (PRI) according to the SF-MPQ was 8.23, with the PRI-sensory and PRI-emotional components 5.23 and 3.00 respectively. The average degree of present pain intensity was 1.86, between mild pain and discomfort, and discomfort was the description most commonly used. The most common pain descriptor was prickling pain, followed by burning pain and bulge pain. 85.7% of the patients felt that their pain had an adverse effect on their affective state, and exhaustion occurred more often than any other descriptive words. Univariant analysis showed that the degree of injury, education level, marital status, monthly income, family support and medication history were all factors correlated with NP perceptions. Multivariate logistic regression analysis showed that being unmarried and severity of injury were independent protective factors against NP. No family support, no medication and low income were independent risk factors for NP. Conclusion The type of neuropathic pain varies in patients with spinal cord injury. The intensity of the pain is mostly at a medium level. The emotional state of most patients was affected. Neuropathic pain involves many factors. Being unmarried and severely injured are independent protective factors, while lack of family support, no medication, and having low income were independent risk factors. |
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