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与损伤相关的慢性疼痛患者的脑震荡后症状

Postconcussion symptoms in patients with injury-related chronic pain.

作者信息

Stålnacke Britt Marie

机构信息

Department of Community Medicine and Rehabilitation, Umeå University Hospital, Umeå University, Building 9A, 90185 Umeå, Sweden.

出版信息

Rehabil Res Pract. 2012;2012:528265. doi: 10.1155/2012/528265. Epub 2012 May 22.

Abstract

Background. Postconcussion symptoms (PCSs)-such as fatigue, headache, irritability, dizziness, and impaired memory-are commonly reported in patients who have mild traumatic brain injuries (MTBIs). Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors. Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ), pain intensity (Visual Analogue Scale), depression, anxiety (Hospital, Anxiety, and Depression Scale), and posttraumatic stress (Impact of Event Scale). Results. Fatigue (90.7%), sleep disturbance (84.9%), headache (73.5%), poor concentration (88.2%), and poor memory (67.1%) were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety. Conclusion. To optimize treatment, it is important to assess each patient's PCS, the mechanism of injury, and factors such as posttraumatic stress and depression.

摘要

背景。脑震荡后症状(PCSs)——如疲劳、头痛、易怒、头晕和记忆力受损——在轻度创伤性脑损伤(MTBIs)患者中很常见。尽管尚不清楚PCSs是否为MTBI所特有,但对MTBI后的PCSs进行评估被认为具有诊断价值。在挥鞭样损伤后,患者最常抱怨头痛和颈部疼痛;对其他PCSs的评估则不那么密切。在因其他损伤而患有慢性疼痛的患者中,PCSs的存在情况尚不清楚。本研究旨在描述与损伤相关疼痛患者中PCSs的发生频率,并研究PCSs、疼痛和心理因素之间的关系。方法。本研究使用问卷收集数据,问卷涉及PCSs(Rivermead脑震荡后问卷,RPQ)、疼痛强度(视觉模拟量表)、抑郁、焦虑(医院焦虑抑郁量表)和创伤后应激(事件影响量表)。结果。疲劳(90.7%)、睡眠障碍(84.9%)、头痛(73.5%)、注意力不集中(88.2%)和记忆力差(67.1%)是一些最常报告的PCSs。在PCSs与创伤后应激、抑郁和焦虑之间发现了显著关系。结论。为了优化治疗,评估每位患者的PCSs、损伤机制以及创伤后应激和抑郁等因素非常重要。

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