急性和亚急性神经病变相关神经性疼痛:系统评价。

Neuropathic Pain in Acute and Subacute Neuropathies: A Systematic Review.

机构信息

Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece.

Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, UK.

出版信息

Pain Physician. 2018 Mar;21(2):111-120.

DOI:
Abstract

BACKGROUND

Neuropathic pain (NP) is a common symptom caused by lesions or diseases of the somatosensory nervous system. Acute/subacute peripheral neuropathies (APN) are rare, however can be particularly painful.

OBJECTIVES

The aim of this systematic review was to estimate the incidence of NP in APN and overview the various etiologies of such neuropathies.

STUDY DESIGN

Systematic review.

SETTING

Medline search.

METHODS

We hand-searched Medline for observational studies published between 1995 and 2017.

RESULTS

Our search strategy identified 1,400 papers. Of these, 70 met our inclusion criteria and were included in this review. Out of a total of 2,341 patients, 1,139 patients were diagnosed with NP (pooled incidence of NP 48.7%). In Guillain-Barré syndrome (GBS), the commonest cause of APN, the pooled estimate of NP was 34.8%. Other causes of painful APN include immune-mediated, vasculitic, metabolic, nutritional, toxic, paraneoplastic, and infectious.

LIMITATIONS

An important limitation was that GBS accounted for the majority of patients with APN, as such the calculated incidence reflected mainly this disease entity. Another important limitation was that very few studies targeted primarily NP. Thus, it is highly likely that observational studies reporting NP were missed. Finally there could always be a publication bias due to underreporting and gray literature.

CONCLUSIONS

NP is a cardinal manifestation of APN. The use of validated diagnostic tools and accepted diagnostic criteria of NP is recommended for both clinical and research purposes.

KEY WORDS

Neuropathic, pain, acute, subacute, neuropathy, polyneuropathy, frequency, incidence.

摘要

背景

神经性疼痛(NP)是由躯体感觉神经系统的损伤或疾病引起的常见症状。急性/亚急性周围神经病变(APN)较为罕见,但可能特别疼痛。

目的

本系统评价旨在估计 APN 中 NP 的发生率,并概述此类神经病变的各种病因。

研究设计

系统评价。

设置

Medline 检索。

方法

我们手动搜索了 1995 年至 2017 年发表的观察性研究的 Medline。

结果

我们的搜索策略确定了 1400 篇论文。其中,有 70 篇符合我们的纳入标准,并被纳入本综述。在总共 2341 名患者中,有 1139 名患者被诊断为 NP(NP 的总发生率为 48.7%)。在 APN 最常见的病因格林-巴利综合征(GBS)中,NP 的汇总发生率为 34.8%。其他引起疼痛性 APN 的原因包括免疫介导、血管炎、代谢、营养、毒性、副肿瘤和感染。

局限性

一个重要的局限性是,GBS 占 APN 患者的绝大多数,因此计算出的发病率主要反映了这种疾病实体。另一个重要的局限性是,很少有研究主要针对 NP。因此,很可能错过了报告 NP 的观察性研究。最后,由于报告不足和灰色文献的存在,可能始终存在发表偏倚。

结论

NP 是 APN 的主要表现。建议在临床和研究目的中使用经过验证的 NP 诊断工具和公认的诊断标准。

关键词

神经性、疼痛、急性、亚急性、神经病、多发性神经病、频率、发生率。

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