CAJ | 학술논문

目的：分析疼痛灾难化对全膝关节置换（ TKA）术后疗效的影响。方法对连续77例因骨关节炎（ OA）行TKA术的患者进行分析。术前进行美国特种外科医院膝关节评分系统（ HSS评分）及疼痛灾难化量表（ PCS）评分检查。术后1年时，进行HSS评分检查及慢性疼痛分析。对术前HSS评分和术前PCS评分，术前HSS和术后HSS评分，术前PCS评分和术后HSS评分进行线性相关检验，对存在慢性疼痛和不存在慢性疼痛的患者进行非配对 t检验。结果患者术前HSS评分与术前PCS评分存在中度负相关关系（r＝－0.6939，P＜0.01）。患者术前HSS评分与术后HSS评分存在高度正相关关系（ r＝0.8132，P＜0.01）。患者术前PCS评分与术后HSS评分存在中度负相关关系（r＝－0.7143，P＜0.01）。术后1年发生慢性疼痛患者8例，无慢性疼痛患者66例。术后慢性疼痛患者与无术后慢性疼痛患者的术前HSS评分（ t＝2.029，P＜0.05）和术前PCS评分（ t＝6.215，P＜0.01），存在统计学差异。结论拟行TKA的换患者存在明显的疼痛灾难化现象，并会对术后慢性疼痛的及关节功能产生影响。
목적：분석동통재난화대전슬관절치환（ TKA）술후료효적영향。방법대련속77례인골관절염（ OA）행TKA술적환자진행분석。술전진행미국특충외과의원슬관절평분계통（ HSS평분）급동통재난화량표（ PCS）평분검사。술후1년시，진행HSS평분검사급만성동통분석。대술전HSS평분화술전PCS평분，술전HSS화술후HSS평분，술전PCS평분화술후HSS평분진행선성상관검험，대존재만성동통화불존재만성동통적환자진행비배대 t검험。결과환자술전HSS평분여술전PCS평분존재중도부상관관계（r＝－0.6939，P＜0.01）。환자술전HSS평분여술후HSS평분존재고도정상관관계（ r＝0.8132，P＜0.01）。환자술전PCS평분여술후HSS평분존재중도부상관관계（r＝－0.7143，P＜0.01）。술후1년발생만성동통환자8례，무만성동통환자66례。술후만성동통환자여무술후만성동통환자적술전HSS평분（ t＝2.029，P＜0.05）화술전PCS평분（ t＝6.215，P＜0.01），존재통계학차이。결론의행TKA적환환자존재명현적동통재난화현상，병회대술후만성동통적급관절공능산생영향。
Objective To analyze the effects of pain catastrophizing on the postoperative effects of total knee arthroplasty ( TKA ) . Methods Seventy-seven patients undergoing TKA because of osteoarthritis were studied .The preoperative scores of the hospital for special surgery ( HSS ) and pain catastrophizing scale ( PCS) were evaluated as well as the postoperative HSS and chronic pain analyzing ( one year after the operation ) .Linear correlation tests of the preoperative HSS and the preoperative PCS , the preoperative HSS and the postoperative HSS , the preoperative PCS and the postoperative HSS were carried out .Unpaired t tests of the patients with and without chronic pain were also performed .Results The results showed that the preoperative HSS and the preoperative PCS were moderately negative correlation (r =-0.6939, P <0.01), the preoperative HSS and the postoperative HSS were highly positive correlation ( r =0.8132, P <0.01 ), while the preoperative PCS and the postoperative HSS were moderately negative correlation (r=-0.7143, P<0.01).One year after the operation, eight patients suffered the chronic pain while 66 patients did not.The preoperative HSS (t=2.029, P<0.05) and the preoperative PCS (t =6.215, P <0.01) of the patients with and without chronic pain were obviously different.Conclusion Pain catastrophizing is remarkable in the patients who accept TKA , which will affect the postoperative chronic pain and the joint functions .