与子宫内膜异位症共存共病疼痛障碍疼痛特征及与日常生活的相关性

本文由“罂粟花”授权转载

与子宫内膜异位症共存：共病疼痛障碍、疼痛特征及与日常生活的相关性

贵州医科大学  麻醉与心脏电生理课题组

翻译：吴学艳   编辑：张中伟   审校：曹莹

  01   背景

疼痛在子宫内膜异位症患者中起着核心作用；疼痛特征、共病疼痛障碍与日常生活之间的复杂关系对医学支持治疗提出了挑战。该项多中心横断面病例对照研究共纳入520例子宫内膜异位症患者，并分析其慢性疼痛与日常生活之间的关系，其中265例(52%)患者经历过慢性疼痛，原因可能为单纯子宫内膜异位症（N=134，26.3%）或与其他疼痛障碍（N=131，25.7%）相关。

  02   方法

采用简明疼痛问卷表和疼痛功能障碍量表自填问卷调查疼痛特征(频率、持续时间、强度)与日常生活之间的关系；此外，还评估了不同子宫内膜异位症特征(rASRM分期、粘连情况、病变部位)与疼痛的关系。

  03   结果

慢性疼痛与所调查的日常生活的几乎所有方面(12/14)呈负相关，包括站立、行走、坐姿、排便、睡眠、体育活动、家庭和家庭责任、性行为、社会功能、职业生涯、情绪和生活乐趣。总而言之，33.7%的慢性疼痛患者日常生活中度受限，27.5%的患者严重受限；其中，共病疼痛障碍可引起更多明显的局限性。疼痛发作时长对患者的家庭/家庭责任(OR 22.94，P<0.001)、职业生活(OR 16.56，P<0.001)和社会功能(OR 41.03，P<0.001)影响尤为显著。

    0 4 结论

研究证实，尽管患者接受治疗，但仍有约50%的女性经历疼痛。疼痛至少对日常生活中所有领域都有中度负面影响；额外的共病疼痛障碍增加了局限性。改善疼痛管理对于提高子宫内膜异位症患者生活质量至关重要。该研究提供了子宫内膜异位症相关疼痛对日常生活影响的准确概述，由于疼痛在子宫内膜异位症患者中扮演着核心角色，尽管有现代的治疗方法，但许多女性仍在遭受慢性疼痛的折磨。我们期待对疼痛危害的更好理解能显著提高这些领域的医学治疗。

  0 5 原始文献来源

Leuenberger J, Kohl Schwartz AS, Geraedts K, et al. Living with endometriosis: Comorbid pain disorders, characteristics of pain, and relevance for daily life[J]. Eur J Pain.2022 Feb 19. DOI: 10.1002/ejp.1926.

英文原文    

Living with endometriosis: Comorbid pain disorders, characteristics of pain, and relevance for daily life

Abstract

Background: Pain plays a central role in endometriosis. The complex relationship among pain characteristics, comorbid pain disorders, and daily life represents a challenge for medical support. This multicenter cross-sectional case-control study analyzed the association between endometriosis-related chronic pain and functions of daily life in 510 women with endometriosis, 265 (52%) of whom experienced chronic pain, either from endometriosis alone (N=134, 26.3%) or in association with additional pain disorders (N=131, 25.7%).

Methods: Self-administered questionnaires from the Brief Pain Inventory and the Pain Disability Index were used to investigate associations between pain characteristics (frequency, duration, intensity) and daily life. Also, associations between different endometriosis characteristics (rASRM stage, presence of adhesions, localization of lesions) and pain were evaluated.

Results: Chronic pain is negatively associated with almost all (12/14) aspects of daily life investigated, including standing, walking, sitting, defecation, sleep, sports activities, family and domestic responsibilities, sexuality, social functioning, professional life, mood, and joy of life. Altogether, 33.7% of women with chronic pain reported moderate and 27.5% severe limitations. Comorbid pain disorders resulted in significantly more limitations. The length of pain episodes showed a particularly important influence, especially for family/domestic responsibilities (OR 22.94, P<0.001), professional life (OR 16.56, P<0.001), and social functioning (OR 41.03, P<0.001).

Conclusions: Our data confirm that despite treatment, about 50% of women experience pain. Pain was associated with at least moderate negative effects on almost all areas of daily life; additional pain comorbidities increased limitations. Improving pain management is essential for improving quality of life in women with endometriosis.utcomes and shorten length of stay.

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