İnmeli hastalarda santral nöropatik ağrı değerlendirilmesi ve yaşam kalitesi ile ilişkisi
Loading...
Files
Date
2018
Authors
Ertem, Uğur
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada inmeli hastalarda santral ağrı görülme sıklığı, santral ağrı oluşumunun serebral lokalizasyonla ilişkisi, inme sonrası santral ağrı oluşumunun yaşam kalitesi ve depresyon ile ilişkisi ve santral ağrı oluşumu ile hastaların demografik özelliklerinin ilişkisinin değerlendirilmesi amaçlanmıştır. Dahil edilme ve dışlama kriterlerini karşılayan 140 hasta çalışmaya alındı. Bu çalışma için özel değerlendirme formu oluşturuldu. Bu formla hastaların demografik özellikleri, inme süresi, geçirmiş olduğu inme sayısı, dominant ekstremitesi, inme etiyopatogenezi, hastaların ambulasyon durumları, hastaların fonksiyonel durumları, ağrılarının bulunup bulunmadığı, kullandıkları ilaçlar ve eşlik eden hastalıkları kaydedildi. Çalışmaya Mini-mental test puanı 20 üzerinde olan hastalar dahil edildi. Nöropatik ağrı değerlendirmesi LANSS ağrı skalası ile yapıldı. Nosiseptif ağrı değerlendirilmesi sözel ağrı ölçeği ile yapıldı. Olguların yaşam kalitesini değerlendirmek için KF-36 anketi kullanıldı. Hastaların depresyon durumunu değerlendirmek için Beck Depresyon Ölçeği kullanıldı. Çalışmaya dahil edilen inme öyküsü olan 140 hastadan 23'ünde inme sonrası santral nöropatik ağrı saptandı. İnme sonrası santral nöropatik ağrı gelişen olgularda hastaların beyanına göre inme zamanından nöropatik ağrı başlangıcına kadar ortalama geçen süre 2 (0-12) aydı. İnme sonrası santral ağrısı olan ve olmayan hastalar arasında demografik veriler açısından sadece kadın cinsiyet ile santral ağrı oluşumu arasında anlamlı bir ilişki saptandı. Santral ağrı oluşumu ile serebral lokalizasyon arasında anlamlı bir fark saptanmazken, hemipleji tarafı ile santral ağrı oluşumu arasında anlamlı ilişki saptandı. Ayrıca santral ağrı oluşumunun KF-36 ölçeğinin ağrı, genel sağlık algısı, sosyal fonksiyon, emosyonel rol kısıtlaması ve mental sağlık alt kategorilerini olumsuz etkilediği belirlendi. Bunun dışında ileri yaş ve santral ağrısı olan hastalarda Beck Depresyon Ölçek puanının daha yüksek olduğu saptandı. Çalışmamızda inme sonrası görülen santral ağrının sık görülen bir sorun olduğu ve hastaların yaşam kalitesini olumsuz etkilediği sonucuna varıldı. Bu yüzden inme sonrasında erken dönemde santral nöropatik ağrı tanınmalı ve buna yönelik tedaviler düzenlenmelidir.
In this study, it was aimed to evaulate the relationship between the occurance of central pain in stroke patients, the relation of central pain formation to cerebral localization, the relationship of central pain formation after stroke to quality of life and depression and the development of central pain and relationship between demographics characteristics of patients. 140 patients who met inclusion and exclusion criteria were included in the study. A special evaluation form was created for this study. Demographic characteristics of patients, stroke duration, number of stroke, dominant extremity, stroke etiopathogenesis, ambulance status of patients, functional status of patients, drugs used were recorded. Patients with a Mini-mental test score above 20 were included in the study. Neuropathic pain assessment was performed with the Leads Assesment of Neuropathic Symptoms and Signs (LANSS) pain scale. Nociceptive pain assessment was performed with verbal pain scale. SF-36 was used to assess the quality of life of the cases. The Beck depression scale was used to assess the depression status of the patients. Central pain was detected after stroke in 23 of 140 patients with stroke history included in this study. In patients with neuropathic pain after stroke, the average time from stroke time to the onset of neuropathic pain is 2 (0-12) months according to the patient's statement. There was a significant difference between the gender and central pain after stroke, but there was no significant relationship between central pain and education status, height, weight. While no significant difference was found between central painful formation and cerebral localization, significant relationship was found between hemiplegia side and central pain formation. In addition, it was found that SF-36 scale of central pain formation adversely affected pain, general health perception, social function, emotional role restriction and mental health subcategories in our study. It was found that Beck depression scale score was higher in patients with advanced age and central pain except this case. It has been shown that central pain after stroke in our study is a common problem and may negatively affect the quality of life of patients. Therefore, interventions should be interrogated and treated in the early period after stroke.
In this study, it was aimed to evaulate the relationship between the occurance of central pain in stroke patients, the relation of central pain formation to cerebral localization, the relationship of central pain formation after stroke to quality of life and depression and the development of central pain and relationship between demographics characteristics of patients. 140 patients who met inclusion and exclusion criteria were included in the study. A special evaluation form was created for this study. Demographic characteristics of patients, stroke duration, number of stroke, dominant extremity, stroke etiopathogenesis, ambulance status of patients, functional status of patients, drugs used were recorded. Patients with a Mini-mental test score above 20 were included in the study. Neuropathic pain assessment was performed with the Leads Assesment of Neuropathic Symptoms and Signs (LANSS) pain scale. Nociceptive pain assessment was performed with verbal pain scale. SF-36 was used to assess the quality of life of the cases. The Beck depression scale was used to assess the depression status of the patients. Central pain was detected after stroke in 23 of 140 patients with stroke history included in this study. In patients with neuropathic pain after stroke, the average time from stroke time to the onset of neuropathic pain is 2 (0-12) months according to the patient's statement. There was a significant difference between the gender and central pain after stroke, but there was no significant relationship between central pain and education status, height, weight. While no significant difference was found between central painful formation and cerebral localization, significant relationship was found between hemiplegia side and central pain formation. In addition, it was found that SF-36 scale of central pain formation adversely affected pain, general health perception, social function, emotional role restriction and mental health subcategories in our study. It was found that Beck depression scale score was higher in patients with advanced age and central pain except this case. It has been shown that central pain after stroke in our study is a common problem and may negatively affect the quality of life of patients. Therefore, interventions should be interrogated and treated in the early period after stroke.
Description
Keywords
İnme, Santral ağrı, Yaşam kalitesi, Depresyon, Stroke, Central pain, Quality of life, Depression
Citation
Ertem, U. (2018). İnmeli hastalarda santral nöropatik ağrı değerlendirilmesi ve yaşam kalitesi ile ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.