Risk factors for chronic pain following breast cancer surgery: A prospective study
Risk factors for chronic pain following breast cancer surgery: A prospective study
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乳腺癌手术后慢性疼痛的危险因素：一项前瞻性研究
DOI：
10.1016/j.jpain.2006.02.007
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发表时间：
2006-09-01
期刊：
影响因子：
4
通讯作者：
Dworkin, Robert H.
中科院分区：
文献类型：
--
作者：
Poleshuck, Ellen L.;Katz, Jennifer;Dworkin, Robert H.
乳腺癌手术后的慢性疼痛与健康相关的生活质量下降有关，并且是已经面临癌症多重压力的女性的额外心理社会困扰的来源。很少有前瞻性研究确定了乳腺癌手术后慢性疼痛的危险因素。对95名计划接受乳腺癌手术的妇女进行了前瞻性的慢性疼痛的人口统计学、临床和心理社会危险因素的评估。在对慢性疼痛的多变量分析中，只有年龄较小与术后3个月发生慢性疼痛的风险显著增加相关。然而，在对慢性疼痛强度的分析中，更具侵入性的手术、术后放射治疗和有临床意义的急性术后疼痛各自独立地预测了术后3个月更强烈的慢性疼痛。术前情绪功能变量并不能独立预测乳腺癌手术后慢性疼痛的存在或强度。这些发现不仅增加了对乳腺癌手术后慢性疼痛的风险因素以及可能导致其发展的过程的理解，而且还为预防干预措施的发展提供了基础。临床变量和严重急性疼痛是乳腺癌手术后慢性疼痛的危险因素，但心理社会压力不是，这为假设急性术后疼痛的积极管理可以减少慢性疼痛提供了基础。(C)2006年，美国疼痛协会。
Chronic pain following breast cancer surgery is associated with decreased health-related quality of life and is a source of additional psychosocial distress in women who are already confronting the multiple stresses of cancer. Few prospective studies have identified risk factors for chronic pain following breast cancer surgery. Putative demographic, clinical, and psychosocial risk factors for chronic pain were evaluated prospectively in 95 women scheduled for breast cancer surgery. In a multivariate analysis of the presence of chronic pain, only younger age was associated with a significantly increased risk of developing chronic pain 3 months after surgery. In an analysis of the intensity of chronic pain, however, more invasive surgery, radiation therapy after surgery, and clinically meaningful acute postoperative pain each independently predicted more intense chronic pain 3 months after surgery. Preoperative emotional functioning variables did not independently contribute to the prediction of either the presence or the intensity of chronic pain after breast cancer surgery. These findings not only increase understanding of risk factors for chronic pain following breast cancer surgery and the processes that may contribute to its development but also provide a basis for the development of preventive interventions.Perspective: Clinical variables and severe acute pain were risk factors for chronic pain following breast cancer surgery, but psychosocial distress was not, which provides a basis for hypothesizing that aggressive management of acute postoperative pain may reduce chronic pain. (C) 2006 by the American Pain Society.