徐沐兰,孙晓龙,吴相波,等.脊髓损伤患者并发神经病理性疼痛危险因素的回顾性研究[J].中华物理医学与康复杂志,2022,44(3):199-203
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| 脊髓损伤患者并发神经病理性疼痛危险因素的回顾性研究 |
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| DOI：10.3760/cma.j.issn.0254-1424.2022.03.002 |
| 中文关键词: 脊髓损伤 神经病理性疼痛 危险因素 回顾性研究 |
| 英文关键词: Spinal cord injury Neuropathic pain |
| 基金项目:国家自然科学基金（82072534）；陕西省重点研发计划-国际科技合作计划项目（2020KW-050）；中国科协“青年人才托举工程”(2018QNRC001) |
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| 中文摘要: |
| 目的 研究脊髓损伤患者并发神经病理性疼痛(NP)的相关危险因素。 方法 回顾性分析2018年1月至2021年12月由空军军医大学第一附属医院康复医学科收治的脊髓损伤患者115例。按病程中是否出现NP，分为NP组（53例）和非NP组（62例）。统计两组患者入院时的性别、年龄、病程、职业、教育程度、发病原因、脊柱骨折情况、脊髓损伤程度及损伤平面、入院时合并症（糖尿病、高血压、贫血、静脉血栓、压疮、泌尿系感染、低蛋白血症）等资料，比较上述因素的组间差异，并应用多因素Logistics回归分析筛选出NP发生的危险因素。 结果 115例脊髓损伤患者中有53例（45.22%）出现NP，其中23例（43.40%）在脊髓损伤后1个月内出现NP，37例（75.47%）NP患者出现脊髓损伤平面以下痛。NP患者的疼痛主要表现为紧束感(33.96%）、麻木感(26.42%）等。多因素Logistics回归分析结果显示，脊髓损伤并发NP与女性［OR=3.210，95%CI（1.198，8.604），P=0.020］、入院时合并静脉血栓［OR=4.813，95%CI（1.874，12.363），P=0.001］有关。 结论 脊髓损伤后NP的发病率较高，女性、入院时合并静脉血栓是住院期间发生NP的独立危险因素，对于这两类患者应及早诊治NP，减轻对患者生活质量的影响。 |
| 英文摘要: |
| Objective To examine the risk factors for neuropathic pain (NP) after a spinal cord injury (SCI). Methods A total of 115 patients with a SCI were analyzed retrospectively. They were divided into an NP group of 53 and a non-NP group of 62 according to the occurrence of NP. Gender, age, length of stay, occupation, level of education, cause of injury, spinal fracture, degree of SCI, the injury′s plane and complications at admission (diabetes, hypertension, anemia, venous thrombosis, pressure sores, urinary tract infection or hypoproteinemia) were recorded. T-tests and chi-squared tests were used to compare those factors between the two groups, and multivariate logistic regressions were evaluated to identify the risk factors for NP. Results Twenty-three of the 53 cases of NP (43%) had developed within 1 month of the SCI. Thirty-seven (75%) experienced pain below the plane of the SCI. The main features reported were squeezing (34%) and numbness (26%). The multivariate logistic regression showed that the occurrence of NP was most strongly related to gender (women being particularly at risk) and venous thrombosis at admission. Conclusions Women are at particular risk of feeling NP after an SCI, and venous thrombosis is an independent risk factor. NP should be diagnosed and treated quickly to reduce the negative impact on patients′ life quality. |
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