| 摘要: |
| 目的对乳腺癌术后患者作流行病学调查，探讨引起乳腺癌术后慢性疼痛（CPSP）的相关因素。方法对322例女性原发性乳腺癌术后患者进行为期9个月的随访调查，分别记录术后3、9个月的10项相关因素，并进行统计学分析。结果术后3、9个月的CPSP发生率分别为61.0%和56.2%，单因素相关分析显示，术后3个月的慢性疼痛相关因素包括：低龄、腋窝淋巴结清扫、中重度术后急性疼痛（VAS评分≥4）（均P＜0.05），而到术后9个月CPSP的相关因素除上述3个因素外，还增加了术前疼痛（P＜0.05）。logistic回归分析显示，乳腺癌术后CPSP的独立危险因素包括低龄、腋窝淋巴结清扫、中重度术后急性疼痛（均P＜0.05）。结论在乳腺癌术后9个月内，术后CPSP的发生率高。减少手术尤其是相关神经的损伤，采取前哨淋巴结活检来替代传统的腋窝淋巴结清扫术式，对低龄患者进行积极干预，积极预防和减轻术后急性疼痛，可能可以减少术后CPSP的发生率，提高患者的生活质量。 |
| 关键词: 乳腺癌 术后慢性疼痛 术后急性疼痛 腋窝淋巴结清扫 |
| DOI： |
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| Risk factors for chronic pain following breast cancer surgery |
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CHEN Ping, YU Linna, ZHANG Fengjiang, YAN Min
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the Second Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To investigate the risk factors of chronic pain after breast cancer surgery. Methods A total of 322 women with primary breast cancer and surgical treatment were retrospectively investigated. A 9-month follow-up survey after surgery was conducted and 10 related factors of chronic pain were recorded on 3 months and 9 months after surgery. The association of chronic pain after breast cancer surgery with each variable was evaluated by logistic regression analysis. Results The incidence of chronic pain on 3 months and 9 months after surgery was 61.0% and 56.2% , respectively. The univariate correlation analysis showed that the chronic pain after 3 months associated with younger age, axillary lymph node dissection and
moderate to severe acute postoperative pain (VAS≥4) (P＜0.05); and preoperative pain syndrome was an additional factor related
to chronic pain after 9 months (P＜0.05). Logistic regression analysis showed that younger age, axillary lymph node dissection, moderate to severe acute postoperative pain were independent risk factors of chronic pain after breast cancer surgery (P＜0.05). Conclusion The incidence of chronic pain after breast cancer surgery is high, which is associated with younger age, axillary lymph node dissection and moderate to severe acute postoperative pain. |
| Key words: Breast cancer Chronic postsurgical pain Acute postoperative pain Axillary lymph node dissection |
