Factors associated with phantom limb pain: a 31/2-year prospective study
Factors associated with phantom limb pain: a 31/2-year prospective study
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DOI：
10.1177/0269215509360645
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发表时间：
2010-05-01
影响因子：
3
通讯作者：
Dijkstra, Pieter U.
中科院分区：
文献类型：
--
作者：
Bosmans, Joline C.;Geertzen, Jan H. B.;Dijkstra, Pieter U.
目的：分析幻肢痛随时间的患病率，并分析截肢者前瞻性队列中与幻肢痛相关的因素。设计：多中心纵向研究。患者：134例计划截肢的患者。方法：患者在截肢前填写问卷，6个月后邮寄问卷，截肢后1年和2年至最多3年。术前评估包括患者的特征、截肢日期、截肢侧位和截肢原因。随访问卷调查评估了幻肢痛的发生频率、假体使用情况和步行距离。幻痛的发生被定义为幻痛一天几次或更频繁。结果：术前和术后的调查问卷填写85截肢者（33名女性和52名男性）。下肢截肢者在截肢后6个月出现幻肢痛的比例最高，上肢截肢者在1年时出现幻肢痛的比例最高。一般来说，女性比男性更多地经历了幻痛。截肢后一年半和两年，最高比例的下肢截肢者每天使用假肢超过4小时（66%），此后这一比例下降到60%。预测幻肢痛的两水平逻辑回归分析结果显示，男性幻肢痛的发生率较低（比值比（OR）= 0.12），下肢截肢者（OR = 0.14），并在适当的时候下降结论：男性、下肢截肢、截肢时间长是幻痛的保护因素。
Objective: To analyse the prevalence of phantom (limb) pain over time and to analyse factors associated with phantom (limb) pain in a prospective cohort of amputees.Design: A multicentre longitudinal study.Patients: One hundred and thirty-four patients scheduled for amputation were included.Methods: Patients filled in questionnaires before amputation, and postal questionnaires six months, 1 years and 2 years to a maximum of 3 years after amputation. Preoperative assessment included patients' characteristics, date, side and level of, and reason for amputation. The follow-up questionnaires assessed the frequencies of the experienced phantom pain, prosthetic use and walking distance. The occurrence of phantom pain was defined as phantom pain a few times a day or more frequently.Results: Pre-and postoperative questionnaires were available filled in by 85 amputees (33 females and 52 males). The percentage of lower limb amputees with phantom pain was the highest at six months after amputation, and of upper limb amputees at 1 years. In general, more women than men experienced phantom pain. One and a half years and 2 years after amputation the highest percentages of the lower limb amputees used their prosthesis more than 4 hours a day (66%), after that time this percentage decreased to 60%. The results of the two-level logistic regression analysis to predict phantom pain show that phantom pain was less frequently present in men (odds ratio (OR) = 0.12), in lower limb amputees (OR = 0.14) and that it decreased in due course (OR = 0.53 for 1 year).Conclusion: Protective factors for phantom pain are: being male, having a lower limb amputation and the time elapsed since amputation.