Predictive Model Construction Of Pain Of Perineal Region And Evaluation Of Clinical Efficacy Of Comprehensive Treatment

ObjectiveTo investigate the risk factors of Pain of Perineal Region and evaluate depression of patients with Perineal Region and explore the feasibility of SF-36 in assessment of health-related quality of life in patients with Pain of Perineal Region.Meanwhile,use SF-36 to assess the effect of the comprehensive treatment of combined drug therapy with CT-guided continuous nerve block in the third posterior sacral foramen of perineal pain.Methods1.A case-control study was conducted on 150 patients with pain in the perineal region(the study group)at Pain Department of Chinese PLA General Hospital and 150 hospitalized physical checkup people without pain in the perineal region(the control group)between April,2017 and May,2018.The study and the control groups were matched in 1:1 ratio in term of age.Suspected risk factors for perineal pain were analyzed by mono-factorial and multi-factorial logistic regression methods.And the probability prediction model of perineal pain was established.2.The reliability,validity of the SF-36 was analyzed.The self-rating depression scale(SDS),visual analogue scale(VAS)and SF-36 health scale were used to evaluate whether there was depression and the degree of depression,pain degree and quality of life in the patients with Pain of Perineal Region.And the comprehensive treatment of combined drug therapy with CT-guided continuous nerve block in the third posterior sacral foramen was evaluated.Results1.Mono-factorial analysis showed significant differences in female patients,negative life events,history of chronic perineal diseases,perineal surgery history,tumor history,between the study and the control groups(P<0.05).Multivariate logistic regression analysis confirmed that negative life events,chronic perineal diseases,perineal surgery were associated with perineal pain(P<0.05),and the establishedmodel with the 3 variables was:P=eY/(1+eY),Y=-0.734+0.677X1+0.051X2+1.025 X3,when optimum critical value P=0.447,the sensitivity of 78.67%and the specificity of 50.01%for predicting Perineal Pain.2.In the eight dimensions of the SF-36 have good credibility(ICC=0.89-0.99).With the exception of a HT coefficient of 0.625,all the other arious dimensions of SF-36 scale was above 0.80.Among 112 patients,32 cases were not associated with depression,80 cases with depression,there were difference between the two group in the physical health and the mental health(P<0.05).The Scores before and after the comprehensive treatment of combined drug therapy with CT-guided continuous nerve block in the third posterior sacral foramen were differences in degree of depression,pain degree and quality of life(P<0.05).ConclusionsNegative life events,chronic perineal diseases,women were found to be the independent risk factors for perineal pain.Most patients with perineal pain are accompanied by depression.Pain and negative emotion seriously affect the life quality of patients with perineal pain.The comprehensive treatment of combined drug therapy with CT-guided continuous nerve block in the third posterior sacral foramen to treat perineal pain can significantly improve the degree of depression,pain degree and quality of life of patients with perineal pain.