Lacoux Philippe A, Crombie Iain K, Macrae William A
Medecins Sans Frontieres, 8, Rue St Sabin, Paris XI, France.
Pain. 2002 Sep;99(1-2):309-12. doi: 10.1016/s0304-3959(02)00154-9.
Data on 40 upper limb amputees (11 bilateral) with regard to stump pain, phantom sensation and phantom pain is presented. All the patients lost their limbs as a result of violent injuries intended to terrorise the population and were assessed 10-48 months after the injury. All amputees reported stump pain in the month prior to interview and ten of the 11 bilateral amputees had bilateral pain. Phantom sensation was common (92.5%), but phantom pain was only present in 32.5% of amputees. Problems in translation and explanation may have influenced the low incidence of phantom pain and high incidence of stump pain. In the bilateral amputees phantom sensation, phantom pain and telescoping all showed bilateral concordance, whereas stump pain and neuromas did not show concordance. About half the subjects (56%) had lost their limb at the time of injury (primary) while the remainder had an injury, then a subsequent amputation in hospital (secondary). There was no association between the incidence of phantom pain and amputation irrespective of being primary or secondary.
本文呈现了40例上肢截肢者（11例双侧截肢）的残端疼痛、幻肢感觉和幻肢痛的数据。所有患者因旨在恐吓民众的暴力伤害而失去肢体，并在受伤后10 - 48个月接受评估。所有截肢者在访谈前一个月均报告有残端疼痛，11例双侧截肢者中有10例双侧疼痛。幻肢感觉很常见（92.5%），但只有32.5%的截肢者存在幻肢痛。翻译和解释方面的问题可能影响了幻肢痛的低发生率和残端疼痛的高发生率。在双侧截肢者中，幻肢感觉、幻肢痛和肢体套叠均表现出双侧一致性，而残端疼痛和神经瘤则未表现出一致性。约一半的受试者（56%）在受伤时（初次）失去肢体，其余患者受伤后在医院进行了后续截肢（二次）。无论初次还是二次截肢，幻肢痛的发生率与截肢之间均无关联。
