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Chronic postsurgical pain and neuropathic symptoms after abdominal hysterectomy: A silent epidemic

机译:腹部子宫切除术后的慢性术后疼痛和神经病变症状:无声的流行病

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摘要

Chronic postsurgical pain (CPSP) is an important clinic problem. It is assessed that prevalence of chronic pain extends to 30% but it is contended that there are various risk factors. We aimed to evaluate the prevalence of chronic pain after hysterectomy, risk factors of chronicity, neuropathic features of pain, and sensorial alterations at surgery area. Between years 2012 and 2015, 16 to 65 ages old patients that electively undergone total abdominal hysterectomy bilateral salpingo-oophorectomy and passed minimum 3 months after surgery were included to study. Visual analog scale (VAS) and Douleur Neuropathique 4-questionnaire (DN-4) surveys were used to evaluate pain symptoms, algometry device was used for evaluating abdominal pressure threshold and Von Frey Filament was used for sensorial alterations. Ninety-three of 165 eligible patients were included to study. As the groups were compared by demographic data, no difference was obtained (P?>?0.05). There was no difference between groups regarding patient and surgery attributes (P?>?0.05). Most frequently performed incision type was Pfannenstiel. Neuropathic symptoms were observed in 90 patients (96.8%). Sensorial alterations as hypoesthesia and hyperesthesia were detected around abdominal scar in 18 patients (19.4%) with pinprick test. Neuropathic symptoms should not be ignored in studies evaluating CPSP and a standard methodology should be designed for studies in this topic.
机译:慢性手术后疼痛(CPSP)是重要的临床问题。据评估,慢性疼痛的患病率扩大至30%,但据认为存在多种危险因素。我们的目的是评估子宫切除术后慢性疼痛的患病率,慢性病的危险因素,疼痛的神经病理特征以及手术部位的感觉改变。在2012年至2015年之间,纳入了16至65岁年龄段的患者,这些患者选择性地接受了全腹子宫全切除术,双侧输卵管卵巢切除术,并且在手术后至少经过了3个月。使用视觉模拟量表(VAS)和Douleur Neuropathique 4问卷(DN-4)来评估疼痛症状,使用血糖仪评估腹压阈值,并使用Von Frey Filament进行感觉改变。 165名合格患者中的93名被纳入研究。当通过人口统计学数据比较各组时,没有差异(P≥0.05)。两组患者和手术属性无差异(P> 0.05)。最常进行的切口类型是Pfannenstiel。在90例患者中观察到了神经性症状(96.8%)。针刺试验在18例患者(19.4%)的腹部疤痕周围检测到感觉改变,如感觉不足和感觉亢进。在评估CPSP的研究中,不应忽略神经性症状,并且应为该主题的研究设计标准方法。

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