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周围神经场刺激治疗慢性疼痛:100 例病例及文献回顾。

Peripheral nerve field stimulation for chronic pain: 100 cases and review of the literature.

机构信息

Metro Spinal Clinic, Caulfield South VIC, Australia.

出版信息

Pain Med. 2011 Sep;12(9):1395-405. doi: 10.1111/j.1526-4637.2011.01201.x. Epub 2011 Aug 3.

Abstract

OBJECTIVE

To evaluate the clinical outcomes of 100 consecutive patients receiving peripheral nerve field stimulation (PNFS) for the treatment of chronic intractable pain.

DESIGN

Prospective, observational study.

SETTING

A private interventional pain specialty referral practice.

PATIENTS

One hundred consecutive private practice patients receiving PNFS for the treatment of chronic craniofacial, thorax, lumbosacral, abdominal, pelvic, and groin pain conditions.

OUTCOME MEASURES

Pain (11-point numerical rating scale), complications, changes to analgesic use and employment status, disability (Oswestry or Neck Disability Indexes), depression (Zung Depression Index), and patient satisfaction.

RESULTS

We demonstrate an average pain reduction of 4.2 ± 2.5 pain scale points on an 11-point scale following PNFS (preimplant pain score of 7.4 ± 1.7 to a follow-up average of 3.2 ± 2.3 pain scale points) (P≤0.00). At a follow-up period of 8.1 ± 4.7 months (range 1-23 months), an overall 72% of patients reduced their analgesic use following PNFS. Patients receiving a lumbosacral PNFS for chronic low back pain reported a significant reduction in disability following treatment, as determined by the Oswestry Disability Index. Of the 100 cases, no long-term complications were reported.

CONCLUSIONS

This prospective 100 consecutive PNFS patient outcome study demonstrates that PNFS can be a safe and effective treatment option for, otherwise, intractable chronic pain conditions. PNFS has the potential to fundamentally change the way we think about pain management.

摘要

目的

评估 100 例连续接受周围神经场刺激(PNFS)治疗慢性难治性疼痛的患者的临床结果。

设计

前瞻性、观察性研究。

设置

一家私立介入疼痛专科转诊诊所。

患者

100 例连续接受 PNFS 治疗慢性颅面、胸、腰、腹、骨盆和腹股沟疼痛的私人执业患者。

结局指标

疼痛(11 点数字评分量表)、并发症、镇痛药物使用和就业状况的变化、残疾(Oswestry 或颈部残疾指数)、抑郁(Zung 抑郁指数)和患者满意度。

结果

我们在 PNFS 后显示出平均疼痛减轻 4.2±2.5 疼痛量表点(植入前疼痛评分 7.4±1.7 至随访平均 3.2±2.3 疼痛量表点)(P≤0.00)。在 8.1±4.7 个月的随访期(1-23 个月),72%的患者在接受 PNFS 后减少了镇痛药物的使用。接受腰骶部 PNFS 治疗慢性腰痛的患者,Oswestry 残疾指数显示残疾程度显著降低。在 100 例病例中,未报告长期并发症。

结论

这项前瞻性的 100 例连续 PNFS 患者结局研究表明,PNFS 可为慢性难治性疼痛状况提供一种安全有效的治疗选择。PNFS 有可能从根本上改变我们对疼痛管理的思维方式。

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