Study On Self-Assessment Of Postoperative Pain And Health-Related Quality Of Life In Patients With Uterine Malignant Tumor Surgery

Objective: The self-rating scale was used to evaluate the correlation between acute postoperative pain(APSP)and health-related quality of life(HRQo L)in patients with uterine malignant tumor surgery,and to screen the factors that affect the early recovery of patients with uterine malignant tumors.Methods: Collected 102 cases of uterine malignant tumor patients who underwent elective surgical treatment in the First Affiliated Hospital of Guangxi Medical University from May 2019 to December 2020.Before surgery(POD1)complete the questionnaire assessment(anxiety self-rating scale,pain catastrophe scale,European five-dimensional health scale)and postoperative day 1(POD1),day 3(POD3),day 7(POD7),the 14 th day(POD14),the 30 th day(POD30)to complete the questionnaire assessment(digital rating scale,European health five-dimensional scale).Results:(1)A total of 102 patients were included in this study,including 2patients who were lost to follow-up on the 7th day after surgery,7 patients who were lost to follow-up on the 14 th day after surgery,and 3 patients who were lost to follow-up on the 30 th day after surgery.A total of 90 patients were followed up,with a loss follow-up rate of 12%.(2)The change trend of APSP and HRQo L in patients within 1 month: The NRS scores of POD1 and POD3 are equivalent;With the prolongation of postoperative time,the most severe NRS score,the average NRS score and the EQ-5D-5L score of patients with uterine malignant tumor surgery showed an overall downward trend,while the EQ-VAS score showed an overall upward trend(P<0.05);EQ-5D-5L and EQ-VAS scores of POD30 basically recovered to preoperative.This indicates that the patient’s pain gradually reduced after the operation,and health status was getting better and better.(3)The correlation between APSP and HRQo L in patients within 1 month:(1)The correlation coefficients between the lightest NRS score and EQ-5D-5L of POD1,POD3 and POD7 after surgery respectively were 0.607,0.740 and 0.481(P<0.05),indicating that there was a positive correlation between the lightest NRS score and EQ-5D-5L of POD1,POD3 and POD7 after surgery.(2)The correlation coefficients between the most severe NRS score and EQ-5D-5L of POD1,POD3,POD7,POD14 and POD30 after operation respectively were0.628,0.776,0.764,0.684 and 0.756(P<0.05),indicating that there was a positive correlation between the most severe NRS score and EQ-5D-5L of POD1,POD3,POD7,POD14 and POD30 after surgery.(3)The correlation coefficients between the average NRS score and EQ-5D-5L of POD1,POD3,POD7,POD14 and POD30 after operation respectively were 0.708,0.827,0.797,0.579,0.539(P<0.05),indicating that there was a positive correlation between the average NRS score and EQ-5D-5L of POD1,POD3,POD7,POD14 and POD30 after surgery.(4)The correlation coefficients between the lightest NRS scores and EQ-VAS of POD1,POD3 and POD7 after surgery respectively were-0.492,-0.456,and-0.383(P<0.05),indicating that there was a negative correlation between the lightest NRS score and EQ-VAS of POD1,POD3 and POD7 after surgery.(5)The correlation coefficients between the most severe NRS score and EQ-VAS of POD1,POD3,POD7,POD14 and POD30 after operation respectively were-0.518,-0.498,-0.421,-0.390,-0.473(P<0.05),indicating that there was a negative correlation between the most severe NRS score and EQ-VAS of POD1,POD3,POD7,POD14 and POD30 after surgery.(6)The correlation coefficients between the average NRS score and EQ-VAS of POD1,POD3,POD7,POD14 and POD30 after operation respectively were-0.538,-0.474,-0.405,-0.413,-0.371(P<0.05),indicating that there was a negative correlation between the average NRS score and EQ-VAS of POD1,POD3,POD7,POD14 and POD30 after surgery.(4)Related factors affecting the early recovery of patients after surgery:The scores of EQ-5D-5L and EQ-VAS on the 7th day after operation were related to the mode of operation and the use of analgesic pump after operation(P<0.05),but not related to age,education level,PCS score,self-rating anxiety scale score,intraoperative use of nerve block and postoperative use of analgesics(P>0.05).In addition,EQ-5D-5L score was also related to the time of getting out of bed for the first time,postoperative hospital stay,postoperative nausea and vomiting(P<0.05).Conclusion:(1)The postoperative health-related quality of life of patients with uterine malignant tumor is closely related to the severity of acute postoperative pain,Good postoperative analgesia can promote the early recovery of patients.(2)Patients with laparoscopic surgery,postoperative use of analgesic pumps,short time to get out of bed for the first time,no nausea and vomiting,and short hospital stay have better early postoperative recovery quality.