【摘要】 目的：探究良性病变子宫肌瘤子宫切除术后并发慢性疼痛(CPHP)的危险因素。方法：回顾性分析2020年6月-2022年6月本院收治的190例因子宫肌瘤行子宫切除术患者临床资料，术后3个月门诊或电话随访，根据数字疼痛评分(NRS)分为CPHP组和非CPHP组，比较两组临床资料，采用单因素和多因素logistic回归分析术后并发CPHP的危险因素。结果：190例患者中发生CPHP 40例(21.1%);两组年龄、体质指数、妊娠次数、腹部手术史、剖宫产、绝经、手术方式、附件切除、手术时间、术后恶心呕吐、合并高血压、合并糖尿病比较无差异(P>0.05);CPHP组术前疼痛评分、术中出血量、子宫内膜异位症或子宫腺肌病、术后急性感染比例高于非CPHP组(P<0.05);合并子宫内膜异位症或子宫腺肌病、术前疼痛评分高是良性病变行子宫切除术后合并CPHP的独立危险因素(P<0.05),且预测术后合并CPHP的曲线下面积(AUC)分别为0.888、0.714。结论：良性病变子宫肌瘤行子宫切除术后并发CPHP几率较高，合并子宫内膜异位症或子宫腺肌病、术前疼痛较严重是术后并发CPHP的独立危险因素。更多还原

【Abstract】 Objective: To explore the risk factors of chronic pain after hysterectomy practice(CPHP) of patients. Methods: The clinical data of 190 patients undergoing hysterectomy due to uterine fibroids from June 2020 to June 2022 were analyzed retrospectively. The outpatient follow-up or telephone follow-up were conducted for these patients in 3 months after surgery. According to the numerical rating score(NRS), these patients were divided into the patients with CPHP in group A and patients without in group B. The clinical data of the patients were compared between the two groups. Univariate and multivariate logistic regression were used to analyze the risk factors of CPHP of the patients. Results: There were 40(21.1%) patients in group A. There were no significant differences in the age, the body mass index, the number of pregnancies, the history of abdominal operation and cesarean section, the menopause situation, the operation mode, the adjunct resection rate, the operation time, the incidences of postoperative nausea and vomiting, hypertension, and diabetes of the patients between the two groups(P>0.05). The preoperative pain score, the intraoperative blood loss, the rates of endometriosis or adenomyosis and postoperative acute infection of the patients in group A were significantly higher than those of the patients in group B(P<0.05). The endometriosis or adenomyosis, and the high preoperative pain score of the patients were the independent risk factors of their CPHP after hysterectomy because of benign lesions(P<0.05). The area under the curve(AUC) of the endometriosis or adenomyosis, and the high preoperative pain score of the patients for predicting their CPHP were 0.888 and 0.714. Conclusion: The rate of CPHP of the patients after hysterectomy because of benign lesions, such as uterine fibroids, is higher. The endometriosis or adenomyosis, and the severe preoperative pain of the patients are the independent risk factors of their CPHP occurrence after hysterectomy.更多还原