Wilkins Krista L, McGrath Patrick J, Finley G Allen, Katz Joel
Department of Nursing, University of Manitoba, Winnipeg, Canada.
Clin J Pain. 2004 Sep-Oct;20(5):293-301. doi: 10.1097/00002508-200409000-00003.
To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs.
Prospective diary study over 1 month.
Fourteen child and adolescent amputees from 10-18 years of age who were missing a limb due to trauma (n = 12) or congenital limb deficiency (n = 2), and who had previously reported having phantom sensations and pain.
Diary used to assess the occurrence of non-painful and painful phantom sensations. Items included age, sex, location and cause of amputation, past experience with stump pain and pre-amputation pain, and intensity, quality, duration, and triggers of the sensations and pains.
Thirteen amputees reported having 104 incidents of non-painful phantom sensations with an average intensity of 4.17 (SD = 2.14) on a 0-10 rating scale. Fifty-three incidents of phantom pain with an average intensity of 6.43 (SD = 1.76) were recorded by 8 amputees. Both amputees with a congenital limb deficiency reported phantom phenomena. Girls reported more psychosocial triggers than did boys whereas boys were more likely than girls to report that they could not identify a trigger (P = 0.0001). Boys also reported a higher proportion of physical triggers than psychosocial triggers while there were no differences for girls (P = 0.0001).
Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers.
前瞻性研究在预先选定的报告有幻肢的儿童和青少年截肢者样本中,与幻肢感觉和疼痛发生相关的因素。
为期1个月的前瞻性日记研究。
14名10至18岁的儿童和青少年截肢者,其中因创伤截肢者12名,先天性肢体缺如者2名,且他们之前均报告有幻肢感觉和疼痛。
用于评估无痛性和疼痛性幻肢感觉发生情况的日记。记录项目包括年龄、性别、截肢部位和原因、既往残端疼痛和截肢前疼痛经历,以及感觉和疼痛的强度、性质、持续时间和触发因素。
13名截肢者报告发生了104次无痛性幻肢感觉事件,在0至10分的评分量表上平均强度为4.17(标准差=2.14)。8名截肢者记录了53次幻肢疼痛事件,平均强度为6.43(标准差=1.76)。两名先天性肢体缺如的截肢者均报告有幻肢现象。女孩报告的心理社会触发因素比男孩多,而男孩比女孩更有可能报告无法确定触发因素(P = 0.0001)。男孩报告的身体触发因素比例也高于心理社会触发因素,而女孩则无差异(P = 0.0001)。
儿童和青少年截肢者在1个月的时间内经常经历幻肢感觉和疼痛。男孩和女孩幻肢现象触发因素的差异可能是由于活动、意识、归因以及报告心理社会触发因素的意愿不同。