Yale S H, Nagib N, Guthrie T
Marshfield Clinic, Wisconsin, USA.
Am Fam Physician. 2000 Mar 1;61(5):1349-56, 1363-4.
The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. Acute episodes of severe pain (crises) are the primary reason that these patients seek medical care in hospital emergency departments. Frequently, however, the pain is incompletely treated. Despite advances in pain management, physicians are often reluctant to give patients adequate dosages of narcotic analgesics because of concerns about addiction, tolerance and side effects. It is important to recognize a pain crisis early, correct the inciting causes, control pain, maintain euvolemia and, when necessary, administer adequate hemoglobin to decrease the hemoglobin S level. The family physician and the hematologist must work together to treat acute pain episodes promptly and effectively, manage the long-term sequelae of chronic pain and prevent future vaso-occlusive crises.
血管闭塞性危机，即镰状细胞危机，是青少年和成人镰状细胞病常见的疼痛并发症。严重疼痛的急性发作（危机）是这些患者到医院急诊科就医的主要原因。然而，疼痛常常得不到充分治疗。尽管疼痛管理有所进展，但由于担心成瘾、耐受性和副作用，医生往往不愿给患者使用足够剂量的麻醉性镇痛药。早期识别疼痛危机、纠正诱发原因、控制疼痛、维持血容量正常，必要时给予足够的血红蛋白以降低血红蛋白S水平非常重要。家庭医生和血液科医生必须共同努力，及时有效地治疗急性疼痛发作，管理慢性疼痛的长期后遗症，并预防未来的血管闭塞性危机。
