Aldington Dominic, Small C, Edwards D, Ralph J, Woods P, Jagdish S, Moore R A
Pain Clinic, Hampshire Hospitals Foundation Trust, Winchester, Hants, UK
J R Army Med Corps. 2014 Mar;160(1):38-41. doi: 10.1136/jramc-2013-000069. Epub 2013 Jul 13.
Amputation is a common injury in survivors of current military conflicts. The primary aim of this study was to establish the prevalence rate of phantom limb pain (PLP) in military personnel undergoing rehabilitation at the UK's Defence Medical Rehabilitation Centre. The secondary aims were to establish treatment failure rates and prevalence rates of phantom limb sensations (PLS) and residual limb pains (RLP).
A questionnaire survey was developed from that used in a previous study of pains in veterans. Questions were asked of the intensity of PLP, RLP and PLS over the previous month and the entire time since amputation. Treatment failure was defined as greater than 'mild' pain. A literature review for similar studies was undertaken.
There were 48 responders with 65 amputations. PLP in the previous month was reported by 49% of respondents and 20% were classed as treatment failures; 76% had PLP at some point and 56% were analgesic failures. PLS was commoner with 70% reported over the previous month and 66% at any time. 65% had RLP over the previous month, 31% were treatment failures and 80% had experienced RLP at some point and 63% of these were failures of treatment. Eight other papers were found for comparison.
This is the first paper that describes prevalence of pains associated with amputation in a serving military population. It also describes the use of analgesic failure as a concept and provides an encouraging rate of as low as 20% in this population.
截肢是当前军事冲突幸存者中的常见损伤。本研究的主要目的是确定在英国国防医疗康复中心接受康复治疗的军事人员中幻肢痛(PLP)的患病率。次要目的是确定治疗失败率以及幻肢感觉(PLS)和残肢痛(RLP)的患病率。
根据先前一项退伍军人疼痛研究中使用的问卷进行了问卷调查。询问了过去一个月以及截肢后整个时间段内PLP、RLP和PLS的强度。治疗失败定义为疼痛程度大于“轻度”。对类似研究进行了文献综述。
有48名受访者,共65处截肢。49%的受访者报告了过去一个月的PLP,20%被归类为治疗失败;76%在某个时间点有过PLP,56%为镇痛失败。PLS更为常见,70%的受访者报告过去一个月有PLS,66%在任何时间有PLS。65%的受访者过去一个月有RLP,31%为治疗失败,80%在某个时间点经历过RLP,其中63%为治疗失败。还找到了其他八篇论文用于比较。
这是第一篇描述现役军人截肢相关疼痛患病率的论文。它还描述了镇痛失败这一概念,并给出了该人群中低至20%的令人鼓舞的比率。