视觉模拟评分评价痔病患者肛门疼痛的有效性和轻中重度界值的确定OA
Effectiveness of Visual Analogue Scale in Assessing Anal Pain in Patients with Hemorrhoids and Determination of Cut-Off Points for Mild,Moderate and Severe Pain
目的:探讨视觉模拟评分(VAS)用于痔病患者肛门疼痛评价的有效性,确立轻、中、重度肛门疼痛的VAS界值和范围.方法:于2021年11月至2022年11月在6 家医院开展横断面调查,采用自拟调查表收集患者一般资料及治疗方式,同步评估VAS、语言描述评分(VRS)、Goligher分级、PATE评分、痔病严重度和手术风险预测评分(HSSP)、简明健康状况调查问卷躯体疼痛维度(BP)评分、中文版痔病和肛裂生命质量量表(HF-QoL-C)评分;绘制受试者工作特征(ROC)曲线确定轻、中、重度疼痛的VAS界值.结果:共纳入痔病患者695例,VAS在不同性别、年龄、文化程度、婚姻状况、经济状况、医疗费用付费方式、体质量指数(BMI)分类患者中差异均无统计学意义(P>0.05);在不同治疗方式(药物/手术)、Goligher分级、VRS分级患者中VAS差异均有统计学意义(P<0.001).VAS与BP评分呈负相关(r=-0.545,P<0.001),与PATE评分(r=0.553,P<0.001)及HSSP评分(r=0.524,P<0.001)呈正相关.痔病患者肛门疼痛VAS分级界限:无疼痛(0 cm≤VAS≤0.2 cm),轻度疼痛(0.2 cm<VAS≤3 cm),中度疼痛(3 cm<VAS≤7 cm),重度疼痛(7 cm<VAS≤10 cm).按此分级后,各组HF-QoL-C总分及其各维度评分、PATE评分、HSSP评分和BP评分差异均有统计学意义(P<0.001).结论:VAS性能稳定,可有效评价痔病患者肛门疼痛强度.推荐痔病患者肛门疼痛VAS分级标准:无疼痛(0 cm≤VAS≤0.2 cm),轻度疼痛(0.2 cm<VAS≤3 cm),中度疼痛(3 cm<VAS≤7 cm),重度疼痛(7 cm<VAS≤10 cm).
Objective To explore the efficacy of Visual Analogue Scale(VAS)in assessing anal pain in patients with hemorrhoids,and to establish the VAS cut-off points and ranges for mild,moderate and severe anal pain.Methods A cross-sectional survey was conducted in 6 hospitals from November 2021 to Novem-ber 2022.A self-designed questionnaire was used to collect patients'general information and treatment meth-ods.VAS,Verbal Rating Scale(VRS),Goligher classification,PATE score,hemorrhoid severity and surgi-cal risk prediction(HSSP)score,bodily pain(BP)dimension score of short form health survey and Chinese version of HEMO-FISS-QoL questionnaire(HF-QoL-C)score were assessed simultaneously.Receiver oper-ating characteristic(ROC)curve was drawn to determine the VAS cut-off points for mild,moderate and severe pain.Results A total of 695 patients with hemorrhoids were included.There were no significant differences in VAS among patients with different genders,educational levels,marital status,economic status,medical payment methods and BMI classifications(P>0.05).There were significant differences in VAS among patients with different treatment methods(drug/surgery),Goligher classifications and VRS classifications(P<0.001).The correlation coefficient(r)between VAS and age was 0.074(P=0.053),which was negatively correlated with BP score(r=-0.545,P<0.001),and positively correlated with PATE score(r=0.553,P<0.001)and HSSP score(r=0.524,P<0.001).The VAS cut-off points of anal pain in patients with hemorrhoids were as follows:no pain(0 cm≤VAS≤0.2 cm),mild pain(0.2 cm<VAS≤3 cm),moderate pain(3 cm<VAS≤7 cm),and severe pain(7 cm<VAS≤10 cm).After classification according to this standard,there were significant differences in the total HF-QoL-C score,its dimension scores,PATE score,HSSP score and BP score among each group(P<0.001).Conclusion VAS has stable performance and can effectively assess the intensity of anal pain in patients with hemorrhoids.It is recommended that the VAS cut-off points for anal pain in patients with hemorrhoids are as follows:no pain(0 cm≤VAS≤0.2 cm),mild pain(0.2 cm<VAS≤3 cm),moderate pain(3 cm<VAS≤7 cm),and severe pain(7 cm<VAS≤10 cm).
孙松朋;龙俊红;周阳洋;褚洪川;刘甲鑫;刘彦;霍兴霄;张书信
北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)北京中医药大学东直门医院肛肠科(北京 100700)
痔病视觉模拟评分语言描述评分有效性分级界值
HemorrhoidsVisual Analogue ScaleVerbal Rating ScaleEffectivenessCut-off points
《中国肛肠病杂志》 2026 (8)
47-54,8
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