髋关节置换术后持续疼痛影响因素的逻辑回归分析

目的探讨影响髋关节置换术后持续疼痛的危险因素。 方法选择2014年1月至2017年6月在增城区新塘医院和南方医院严格按照纳入和排除标准收集的髋关节置换术的814例患者作为研究对象。收集患者临床资料，观察临床资料与术后持续性疼痛的相关性，单因素分析采用卡方检验，多因素分析采用逻辑回归(logistic)分析。 结果单因素分析显示，吸烟不是影响髋关节置换术后持续性疼痛的因素(χ²＝0.814，P>0.05)，性别、年龄、身体质量指数、饮酒、长期镇痛药物应用、置换类型、假体类型、手术时间、麻醉持续时间、髋关节活动时间、术后C反应蛋白(CRP)是影响髋关节置换术后持续性疼痛的因素(χ²＝11.826、14.705、12.344、4.184、15.279、10.140、9.837、8.862、16.019、12.864、23.485，P<0.05)。多因素logistic分析结果显示年龄<60岁、身体质量指数>28 kg/m²、髋关节活动时间≤2 d是影响髋关节置换术后持续疼痛的独立危险因素(waldχ²＝13.716、18.948、15.423，P<0.05)。 结论髋关节置换术后持续性疼痛是多因素综合作用的结果，临床工作中应考虑对这些因素进行针对性防控，以降低髋关节置换术后持续性疼痛的发生率。

Logistic analysis of the influencing factors of persistent pain after hip replacement

ObjectiveTo explore the risk factors for persistent pain after hip replacement. MethodsFrom January 2014 to June 2017, 814 patients with hip arthroplasty who were collected in Xintang Hospital of Zengcheng District and Southern Hospital in strict accordance with inclusion and exclusion criteria were selected as the subjects of study. Clinical data of patients were collected to observe the correlation between clinical data and postoperative persistent pain. Chi-square test was used for univariate analysis and logistic regression analysis was used for multivariate analysis. ResultsThe univariate analysis showed that smoking was not a factor affecting persistent pain after hip replacement (χ²=0.814, P>0.05), sex, age, body mass index, alcohol consumption, long-term analgesic use, type of replacement, type of prosthesis, operation time, duration of anesthesia, time of hip joint movement, post-operative C-reactive protein(C-reactive protein, CRP) were factors affecting persistent pain following hip replacement (χ²=11.826, 14.705, 12.344, 4.184, 15.279, 10.140, 9.837, 8.862, 16.019, 12.864, 23.485, all P<0.05). The multivariate logistic analysis showed that age less than 60 years, body mass index greater than 28 kg/m^2, hip joint activity time less than or equal to two days were independent risk factors for persistent pain after hip replacement (wald χ²=13.716, 18.948, 15.423, all P<0.05). ConclusionThe continuous pain after hip replacement is the result of multiple factors, these factors should be taken into consideration for targeted prevention and control, so as to reduce the incidence of persistent pain after hip replacement.