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基层医疗中腰痛的管理

Managing Low Back Pain in Primary Care.

作者信息

Kamal Kamal Constantin, Alexandru DragoŞ Ovidiu, Kamal Diana, Maria Daniela Teodora, Kamal Adina Maria, Radu Mirela, TrĂistaru Magdalena Rodica

机构信息

Department of Family Medicine, University of Medicine and Pharmacy of Craiova, Romania.

Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2020 Oct-Dec;46(4):396-404. doi: 10.12865/CHSJ.46.04.11. Epub 2020 Dec 31.

DOI:10.12865/CHSJ.46.04.11
PMID:33717515
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7948016/
Abstract

Low back pain (LBP) is one of the most common pathologies for which patients present for consultation in primary medical practice. The objective of the study was to determine the number of patients with LBP who presented to the general practitioner 's (GP) office between October 2019 and March 2020, to determine risk factors, favoring factors and their correlation with clinical data obtained after performing the clinical examination, with paraclinical data obtained by imaging investigation. 347 patients, aged between 17 and 82 years, were included in the study, presenting a sex ratio of men: women of approximately 2: 1. The main pain symptoms of the patients were: localized pain in the lumbar spine, radicular pain, referred to the lower limbs, subjective sensitivity disorders felt in the lower limbs, distal motor deficit in the lower limbs, paravertebral muscle contractions and the feeling of instability in the low back. The main risk factors were smoking, the existence of a trauma to the lumbar spine, sedentary lifestyle, maintaining a prolonged fixed position and intense physical exercise, either occasionally or daily. Among the patients included in the study, a number of 93 patients required the granting of medical leave both by the attending GP and by other specialists. Regardless of the etiology and pathophysiological mechanisms involved in the occurrence of LBP, therapeutic management should aim to stop pain symptoms and prevent recurrences.

摘要

腰痛(LBP)是患者在基层医疗实践中求诊的最常见病症之一。该研究的目的是确定2019年10月至2020年3月期间到全科医生(GP)办公室就诊的腰痛患者数量,确定危险因素、有利因素及其与临床检查后获得的临床数据、影像学检查获得的辅助临床数据之间的相关性。347名年龄在17至82岁之间的患者被纳入研究,男女比例约为2:1。患者的主要疼痛症状为:腰椎局部疼痛、下肢放射性疼痛、下肢主观感觉障碍、下肢远端运动功能障碍、椎旁肌收缩以及腰部不稳定感。主要危险因素为吸烟、腰椎创伤史、久坐不动的生活方式、长时间保持固定姿势以及偶尔或日常的剧烈体育锻炼。在纳入研究的患者中,有93名患者需要主治全科医生和其他专科医生开具病假条。无论腰痛发生的病因和病理生理机制如何,治疗管理都应旨在消除疼痛症状并预防复发。

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Mechanical Low Back Pain.机械性下背痛。
慢性下腰痛患者是否存在心理共病?
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Mayo Clin Proc. 2015 Dec;90(12):1699-718. doi: 10.1016/j.mayocp.2015.10.009.
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