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全臂丛神经撕脱伤患者神经性疼痛的临床特征:一项30例病例研究。

The clinical characteristics of neuropathic pain in patients with total brachial plexus avulsion: A 30-case study.

作者信息

Zhou Yingjie, Liu Peixi, Rui Jing, Zhao Xin, Lao Jie

机构信息

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200032, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200032, China.

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 20040, China.

出版信息

Injury. 2016 Aug;47(8):1719-24. doi: 10.1016/j.injury.2016.05.022. Epub 2016 May 18.

Abstract

UNLABELLED

Neuropathic pain in patients with total brachial plexus avulsion has always been a sophisticated problem in clinical practice.

OBJECTIVES

For further researches on objective diagnosis, alleviation or even cure of neuropathic pain, we need to conclude the basic clinical features including pain intensity, distribution, type and possible risk factors.

METHODS

Thirty cases of patients with total brachial plexus avulsion were included and their baseline information was collected. Pain was evaluated by Present Pain Index using a visual analog scale; Douleur Neuropathique 4 was used for screening neuropathic pain. For more detailed pain description, the Neuropathic Pain Symptoms Inventory questionnaire and a picture showing the exact pain district were both fulfilled by all the eligible participants. The relationship between neuropathic pain and basic information, injury conditions, accompanied conditions and quality of life was tested.

RESULTS

All the participants were male in both groups. The neuropathic pain group contained 22 patients (73.33%) with the mean age of 30.18±9.47; while 29.00±7.95 in the other group. Patients with neuropathic pain presented variously in pain degree, location, type and time phase, according to the results of the Neuropathic Pain Symptoms Inventory questionnaire. Nevertheless, most pain distributed on the region of hand. Among several related factors, alcohol abuse may be possible risk factors of neuropathic pain (p=0.03). Quality of life was significantly affected by pain (p<0.01).

CONCLUSION

Neuropathic pain in patients with total brachial avulsion was characterized with heterogeneity in pain distribution, intensity, type and also time phase. Bad life habits might be risk factors associated with neuropathic pain. Neuropathic pain might affect quality of life of the patients with total brachial plexus avulsion remarkably.

摘要

未标注

全臂丛神经撕脱伤患者的神经性疼痛一直是临床实践中的一个复杂问题。

目的

为了进一步研究神经性疼痛的客观诊断、缓解甚至治愈方法,我们需要总结其基本临床特征,包括疼痛强度、分布、类型及可能的危险因素。

方法

纳入30例全臂丛神经撕脱伤患者并收集其基线信息。采用视觉模拟量表通过现痛指数评估疼痛;使用神经病理性疼痛4量表筛查神经性疼痛。所有符合条件的参与者均完成神经病理性疼痛症状量表问卷及一张显示确切疼痛区域的图片,以进行更详细的疼痛描述。检测神经性疼痛与基本信息、损伤情况、伴随情况及生活质量之间的关系。

结果

两组参与者均为男性。神经性疼痛组有22例患者(73.33%),平均年龄为30.18±9.47岁;另一组为29.00±7.95岁。根据神经病理性疼痛症状量表问卷结果,神经性疼痛患者在疼痛程度、部位、类型和时间阶段上表现各异。然而,大多数疼痛分布在手部区域。在几个相关因素中,酗酒可能是神经性疼痛的危险因素(p=0.03)。生活质量受疼痛影响显著(p<0.01)。

结论

全臂丛神经撕脱伤患者的神经性疼痛在疼痛分布、强度、类型及时间阶段上具有异质性。不良生活习惯可能是与神经性疼痛相关的危险因素。神经性疼痛可能会显著影响全臂丛神经撕脱伤患者的生活质量。

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