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国际疼痛学会(IASP)ICD-11 慢性疼痛分类:慢性手术后或创伤后疼痛。

The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain.

机构信息

Discipline of Anaesthesiology and Pain Medicine, Medical School, University of Western Australia, Perth, Australia.

Department of Anesthesiology and Acute Postoperative Pain Service, Saint Luc Hospital, Catholic University of Louvain, Brussels, Belgium.

出版信息

Pain. 2019 Jan;160(1):45-52. doi: 10.1097/j.pain.0000000000001413.

Abstract

Chronic pain after tissue trauma is frequent and may have a lasting impact on the functioning and quality of life of the affected person. Despite this, chronic postsurgical and posttraumatic pain is underrecognised and, consequently, undertreated. It is not represented in the current International Classification of Diseases (ICD-10). This article describes the new classification of chronic postsurgical and posttraumatic pain for ICD-11. Chronic postsurgical or posttraumatic pain is defined as chronic pain that develops or increases in intensity after a surgical procedure or a tissue injury and persists beyond the healing process, ie, at least 3 months after the surgery or tissue trauma. In the classification, it is distinguished between tissue trauma arising from a controlled procedure in the delivery of health care (surgery) and forms of uncontrolled accidental damage (other traumas). In both sections, the most frequent conditions are included. This provides diagnostic codes for chronic pain conditions that persist after the initial tissue trauma has healed and that require specific treatment and management. It is expected that the representation of chronic postsurgical and posttraumatic pain in ICD-11 furthers identification, diagnosis, and treatment of these pain states. Even more importantly, it will make the diagnosis of chronic posttraumatic or postsurgical pain statistically visible and, it is hoped, stimulate research into these pain syndromes.

摘要

组织创伤后的慢性疼痛很常见,可能会对受影响者的功能和生活质量产生持久影响。尽管如此,慢性手术后和创伤后疼痛仍未得到充分认识,因此治疗不足。它未在当前的国际疾病分类(ICD-10)中体现。本文描述了 ICD-11 中用于慢性手术后和创伤后疼痛的新分类。慢性手术后或创伤后疼痛被定义为在手术或组织损伤后出现或强度增加的慢性疼痛,并在愈合过程后持续存在,即在手术后或组织创伤后至少 3 个月。在分类中,它区分了源自医疗保健提供过程中(手术)的受控程序和不受控制的意外损伤(其他创伤)引起的组织创伤。在这两个部分中,都包含了最常见的情况。这为初始组织创伤愈合后持续存在的慢性疼痛状况提供了诊断代码,这些疼痛状况需要特定的治疗和管理。预计 ICD-11 中对慢性手术后和创伤后疼痛的表示将有助于这些疼痛状况的识别、诊断和治疗。更重要的是,它将使慢性创伤后或手术后疼痛的诊断在统计学上可见,并希望能促进对这些疼痛综合征的研究。

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