急性胰腺炎患者急性期疼痛现状及其对住院时间的影响

目的　调查急性胰腺炎患者急性期疼痛现状，并分析其对住院时间的影响。方法　于2015年11月—2016年6月，采取方便取样方法选取苏州大学附属第一医院和苏州大学附属第二医院两所三级甲等医院的急性胰腺炎患者。收集患者的人口学资料及临床资料，记录疼痛累计时间，并应用国际通用的数字分级法（NRS）进行疼痛评分。结果　共发放问卷178份，回收160份，其中有效问卷150份，有效回收率为84.3%。150例患者疼痛累计总时间为48（30，60）h，入院0~<2 h中重度疼痛发生率为98.7%（148/150），中重度疼痛累计时间为2（2，2）h；入院2~<12 h中重度疼痛发生率为94.7%（142/150），中重度疼痛累计时间为5（3，8）h；入院12~<24 h中重度疼痛发生率为47.3%（71/150），中重度疼痛累计时间为0（0，4）h；入院24~<48 h中重度疼痛发生率为7.3%（11/150），中重度疼痛累计时间为0（0，0）h。入院不同时间段（0~<2、2~<12、12~<24、24~<48 h）患者中重度疼痛发生率、疼痛严重程度（NRS评分）比较，差异均有统计学意义（P<0.05）。患者住院时间为（11.4±5.5）d。相关性分析结果显示：胸腔积液情况、腹腔积液情况、Ranson评分≥3分、并发症情况、疼痛累计总时间、入院2~<12 h中重度疼痛累计时间、入院12~<24 h中重度疼痛情况、入院24~<48 h中重度疼痛情况、入院24~<48 h NRS评分与住院时间有相关关系（P<0.05）。多元线性回归分析结果显示：腹腔积液（B=2.524）、Ranson评分（B=3.905）、疼痛累计总时间（B=0.063）、入院0~<2 h中重度疼痛累计时间（B=-3.583）是急性胰腺炎患者住院时间的影响因素（P<0.05）。结论　急性胰腺炎患者急性期疼痛持续时间较长，且疼痛程度严重。临床上应重视轻度疼痛资料的收集，同时需要给予患者积极有效的疼痛干预来缩短住院时间。

Investigation of Acute Pain in Patients with Acute Pancreatitis and Its Influence on Hospitalization Time

Objective　To investigate the acute pain symptoms in patients with acute pancreatitis and to analyze its influence on hospitalization time.Methods　Patients with acute pancreatitis who were admitted to the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University between November 2015 and June 2016 were selected through a convenient sampling method.The patients' demographic data，clinical materials were collected.The cumulative time of pain was recorded. The degree of pain was assessed using an internationally adapted numerical rating scale （NRS）.Results　A total of 178 questionnaires were distributed，and 160 were returned，of which 150 were valid；the effective recovery rate was 84.3%.The cumulative pain time for the 150 patients was 48（30，60）h，the incidence of moderate-to-severe pain 0 to <2 h after admission was 98.7% （148/150），and the cumulative time of moderate-to-severe pain was 2 （2，2） h.The incidence of moderate-to-severe pain 2 to <12 h after admission was 94.7% （142/150），and the cumulative time of moderate-to-severe pain was 5 （3，8） h.The incidence of moderate-to-severe pain 12 to <24 h after admission was 47.3% （71/150），and the cumulative time of moderate-to-severe pain was 0 （0，4） h.The incidence of moderate-to-severe pain 24 to <48 h after admission was 7.3% （11/150），and the cumulative time of moderate-to-severe pain was 0 （0，0） h.There were significant differences in the incidence of moderate-to-severe pain and severity of pain （NRS scores） in different time periods （0 to<2 h，2 to <12 h，12 to <24 h，and 24 to <48 h） （P<0.05）.The hospitalization time was （11.4±5.5） d.Correlation analysis showed that pleural effusion，ascites fluid，Ranson score，complications，cumulative total pain time，cumulative time of moderate-to-severe pain at 2 to <12 h，incidence of moderate-to-severe pain at 12 to <24 h，incidence of moderate-to-severe pain at 24 to <48 h，and NRS scores at 24 to <48 h were correlated with hospitalization time （P<0.05）.Multivariate linear regression analysis showed that ascites fluid （B=2.524），Ranson score （B=3.905），cumulative total pain time （B=0.063），and cumulative time of moderate-to-severe pain at 0 to <2 h （B=-3.583） were factors influencing patient hospitalization time （P<0.05）.Conclusion　Patients with acute pancreatitis have a long duration of pain in the acute phase，and the pain is relatively severe.Clinicians should pay attention to the collection of mild pain data and take active and effective measures to intervene to shorten hospitalization time.