Zhou Yingjie, Liu Peixi, Rui Jing, Zhao Xin, Lao Jie
*Department of Hand Surgery §Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai †Key Laboratory of Hand Reconstruction, Ministry of Health ‡Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
Clin J Pain. 2017 Nov;33(11):1030-1036. doi: 10.1097/AJP.0000000000000493.
Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients.
The clinical features of neuropathic pain, including pain intensity, type and time phase, need to be investigated. Moreover, possible associated factors need to be explored.
A cross-sectional study containing 77 participants was conducted. Their baseline information and injury-related conditions were collected. The Present Pain Index evaluated by the Visual Analog Scale, self-reports using the specific pain questionnaires were used for screening and estimating the patients' pain. T test, χ test, Logistic Regression, and correlation coefficient were used when conducting the statistical analyses.
The occurrence rate of neuropathic pain in our study was 54.5%. Paresthesia/dysesthesia had the highest average score in our population. Among potential associated factors, smoking (P=0.001), regular alcohol drinking (P=0.001), total brachial plexus injuries (P=0.01), and avulsions (P=0.019) were related to the development of neuropathic pain. Patients with neuropathic pain experienced significantly poorer function of the upper limbs measured by the Disabilities of Arm, Hand and Shoulder questionnaire (P<0.01). There was a significant positive correlation between the function of the upper limbs and pain intensity (r=0.60, P<0.001).
Though the pain type and time phase manifested differently across patients, paresthesia/dysesthesia occurred most commonly. Patients were more likely to develop neuropathic pain if they had total brachial plexus injuries, avulsion and bad life habits. Moreover, the function of the upper limbs was affected by pain.
臂丛神经损伤患者的神经性疼痛给外科医生和患者的治疗及康复带来了复杂的障碍。
需要研究神经性疼痛的临床特征，包括疼痛强度、类型和时间阶段。此外，还需要探索可能的相关因素。
进行了一项包含77名参与者的横断面研究。收集了他们的基线信息和与损伤相关的情况。使用视觉模拟量表评估的当前疼痛指数，以及使用特定疼痛问卷的自我报告，用于筛查和评估患者的疼痛。进行统计分析时使用了t检验、χ检验、逻辑回归和相关系数。
我们研究中神经性疼痛的发生率为54.5%。感觉异常/感觉迟钝在我们的研究人群中平均得分最高。在潜在的相关因素中，吸烟（P = 0.001）、经常饮酒（P = 0.001）、全臂丛神经损伤（P = 0.01）和撕脱伤（P = 0.019）与神经性疼痛的发生有关。通过手臂、手部和肩部功能障碍问卷测量，神经性疼痛患者的上肢功能明显较差（P < 0.01）。上肢功能与疼痛强度之间存在显著正相关（r = 0.60，P < 0.001）。
尽管不同患者的疼痛类型和时间阶段表现不同，但感觉异常/感觉迟钝最为常见。如果患者有全臂丛神经损伤、撕脱伤和不良生活习惯，则更有可能发生神经性疼痛。此外，上肢功能受到疼痛的影响。
