CAJ | 학술논문

目的探讨五一二四川地震27个月后骨折伤员慢性疼痛的相关因素和疼痛程度与生活质量的关系.方法回访705例四川省绵竹市五一二地震骨折伤员,按视觉模拟评分(VAS)分为无疼痛、轻度疼痛、中度疼痛和重度疼痛组.通过现场评估和问卷调查伤员手术和康复情况、情绪状态、职业和经济、巴塞尔指数(BI)、生活满意度问卷( LiSat-11)、简明健康调查(SF-36)量表,分析与疼痛有关的生物、心理和社会因素,并确定疼痛强度与生活质量的关系.结果五一二地震27个月后,骨折伤员慢性疼痛发生率为88.5％,其中轻度和中度疼痛分别占35.7％和33.3％.骨折手术率为65.8％,愈合率为96.9％.4组伤员BI分别为(92.7+10.2)分,(92.8±8.4)分,(91.2±9.9)分,(90.4±14.7)分,差异无统计学意义(P＞0.05).疼痛程度对生活满意度的影响,差异呈线性趋势(P＜0.05).4组伤员职业能力受到限制的比例分别为38.3％、61.5％、75.7％和62.8％；其家人的平均年收入用中位数(第1四分位数,第3四分位数)[M(QL,Qu)]表示,分别为3550元(1620元,6000元),2500元(1225元,4800元),2000元(1200元,4000元),2500元(1200元,4000元).疼痛程度与年收入呈线性趋势(P＜0.05).与慢性疼痛相关的因素主要有异常情绪、生活满意度、职业能力和年收入.4组伤员间SF-36量表的8个领域(生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能和精神健康)评分比较,差异均有统计学意义(P＜0.05),其中无疼痛组SF-36总分为(70.6±17.5)分,轻度疼痛组为(61.3±14.3)分,中度疼痛组(52.7±14.3)分,重度疼痛组为(52.3±14.7)分.疼痛程度与伤员生活质量呈负相关.结论五一二四川地震27个月后,大部分地震骨折伤员仍合并慢性疼痛,与心理-社会因素和生活质量相关.
목적 탐토오일이사천지진27개월후골절상원만성동통적상관인소화동통정도여생활질량적관계.방법 회방705례사천성면죽시오일이지진골절상원,안시각모의평분(VAS)분위무동통、경도동통、중도동통화중도동통조.통과현장평고화문권조사상원수술화강복정황、정서상태、직업화경제、파새이지수(BI)、생활만의도문권( LiSat-11)、간명건강조사(SF-36)량표,분석여동통유관적생물、심리화사회인소,병학정동통강도여생활질량적관계.결과 오일이지진27개월후,골절상원만성동통발생솔위88.5％,기중경도화중도동통분별점35.7％화33.3％.골절수술솔위65.8％,유합솔위96.9％.4조상원BI분별위(92.7+10.2)분,(92.8±8.4)분,(91.2±9.9)분,(90.4±14.7)분,차이무통계학의의(P＞0.05).동통정도대생활만의도적영향,차이정선성추세(P＜0.05).4조상원직업능력수도한제적비례분별위38.3％、61.5％、75.7％화62.8％；기가인적평균년수입용중위수(제1사분위수,제3사분위수)[M(QL,Qu)]표시,분별위3550원(1620원,6000원),2500원(1225원,4800원),2000원(1200원,4000원),2500원(1200원,4000원).동통정도여년수입정선성추세(P＜0.05).여만성동통상관적인소주요유이상정서、생활만의도、직업능력화년수입.4조상원간SF-36량표적8개영역(생리공능、생리직능、구체동통、총체건강、활력、사회공능、정감직능화정신건강)평분비교,차이균유통계학의의(P＜0.05),기중무동통조SF-36총분위(70.6±17.5)분,경도동통조위(61.3±14.3)분,중도동통조(52.7±14.3)분,중도동통조위(52.3±14.7)분.동통정도여상원생활질량정부상관.결론 오일이사천지진27개월후,대부분지진골절상원잉합병만성동통,여심리-사회인소화생활질량상관.
Objective To investigate factors related to chronic pain in those injured with fractures 27 months after the Sichuan earthquake.The correlation between intensity of pain and quality of life was also analyzed.Methods A total of 705 victims were investigated on site.Their residual pain was categorized using a visual analogue scale (VAS) score as no pain,mild pain,moderate pain or severe pain.The pain-related biological,psychological and social factors were analyzed using the Barthel Index ( BI ),Life Satisfaction Questionaire-11 ( LiSat-11 )and the SF-36 health questionnaire. Rehabilitation and surgical interventions,employment,income and emotional status were also investigated. Results The incidence of chronic pain was 88.5％ in this population,of which mild pain and moderate pain were 35.7％ and 33.3％,respectively.The percentage of the victims who had received fracture surgery was 65.8％ ; the percentage of those who had recovered was 96.9％.BI scores for the victims without pain,with mild,moderate and severe pain were 92.7 + 10.2,92.8 + 8.4,91.2 ± 9.9 and 90.4 + 14.7,respectively ; the differences between these groups were all statistically insignificant.The influence of pain intensity on life satisfaction showed a significant linear trend.The percentages of the victims with restricted occupational ability in the four groups were 38.3％,61.5％,75.7％ and 62.8％ respectively.The median of personal annual income were ￥ 3550,￥ 2500,￥ 2000 and ￥ 2500.The VAS scores were significantly related to abnormal emotions,life satisfaction,employment and annual income.The subjects with different levels of residual pain also showed significant differences in the physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional and mental health sub-scales of the SF-36.The total SF-36 scores were highest among victims without pain (70.6 + 17.5) and declined significantly in those with mild (61.3 + 14.3 ),moderate (52.7 + 14.3 ) and severe pain (52.3 + 14.7 ).This negative correlation between pain intensity and SF-36 total score was statistically significant. Conclusions Chronic pain remains common among fracture victims 27 months after the earthquake.Its intensity is correlated with psychological and social factors as well as quality of life.