转至康复中心的脊髓损伤患者中神经性疼痛的患病率及特征
Prevalence and Characteristics of Neuropathic Pain in Patients With Spinal Cord Injury Referred to a Rehabilitation Center.
作者信息
Kim Hae Young, Lee Hye Jin, Kim Tae-Lim, Kim EunYoung, Ham Daehoon, Lee Jaejoon, Kim Tayeun, Shin Ji Won, Son Minkyoung, Sung Jun Hun, Han Zee-A
机构信息
Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea.
出版信息
Ann Rehabil Med. 2020 Dec;44(6):438-449. doi: 10.5535/arm.20081. Epub 2020 Dec 31.
OBJECTIVE
To identify the prevalence and characteristics of neuropathic pain (NP) in patients with spinal cord injury (SCI) and to investigate associations between NP and demographic or disease-related variables.
METHODS
We retrospectively reviewed medical records of patients with SCI whose pain was classified according to the International Spinal Cord Injury Pain classifications at a single hospital. Multiple statistical analyses were employed. Patients aged <19 years, and patients with other neurological disorders and congenital conditions were excluded.
RESULTS
Of 366 patients, 253 patients (69.1%) with SCI had NP. Patients who were married or had traumatic injury or depressive mood had a higher prevalence rate. When other variables were controlled, marital status and depressive mood were found to be predictors of NP. There was no association between the prevalence of NP and other demographic or clinical variables. The mean Numeric Rating Scale (NRS) of NP was 4.52, and patients mainly described pain as tingling, squeezing, and painful cold. Females and those with below-level NP reported more intense pain. An NRS cut-off value of 4.5 was determined as the most appropriate value to discriminate between patients taking pain medication and those who did not.
CONCLUSION
In total, 69.1% of patients with SCI complained of NP, indicating that NP was a major complication. Treatment planning for patients with SCI and NP should consider that marital status, mood, sex, and pain subtype may affect NP, which should be actively managed in patients with an NRS ≥4.5.
目的
确定脊髓损伤(SCI)患者中神经性疼痛(NP)的患病率及特征,并研究NP与人口统计学或疾病相关变量之间的关联。
方法
我们回顾性分析了一家医院中根据国际脊髓损伤疼痛分类法对疼痛进行分类的SCI患者的病历。采用了多种统计分析方法。排除了年龄<19岁的患者以及患有其他神经系统疾病和先天性疾病的患者。
结果
在366例患者中,253例(69.1%)SCI患者患有NP。已婚、有创伤性损伤或抑郁情绪的患者患病率较高。在控制其他变量后,发现婚姻状况和抑郁情绪是NP的预测因素。NP的患病率与其他人口统计学或临床变量之间无关联。NP的平均数字评分量表(NRS)为4.52,患者主要将疼痛描述为刺痛、压榨痛和冷痛。女性和下肢NP患者报告的疼痛更强烈。确定NRS临界值4.5为区分服用止痛药物和未服用止痛药物患者的最合适值。
结论
总体而言,69.1%的SCI患者主诉有NP,表明NP是一种主要并发症。对于SCI和NP患者的治疗计划应考虑到婚姻状况、情绪、性别和疼痛亚型可能影响NP,对于NRS≥4.5的患者应积极进行处理。