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一项针对3374名单侧肢体截肢者的全国性调查中幻肢痛和无痛性幻肢现象的患病率及特征

The Prevalence and Characteristics of Phantom Limb Pain and Non-Painful Phantom Phenomena in a Nationwide Survey of 3,374 Unilateral Limb Amputees.

作者信息

Diers Martin, Krumm Bertram, Fuchs Xaver, Bekrater-Bodmann Robin, Milde Christopher, Trojan Jörg, Foell Jens, Becker Susanne, Rümenapf Gerhard, Flor Herta

机构信息

Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany.

Division of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

J Pain. 2022 Mar;23(3):411-423. doi: 10.1016/j.jpain.2021.09.003. Epub 2021 Sep 25.

Abstract

The experience of phantom limb pain (PLP) is a common consequence of limb amputation, resulting in severe impairments of the affected person. Previous studies have shown that several factors such as age at or site of amputation are associated with the emergence and maintenance of PLP. In this cross-sectional study we assessed the presence of several phantom phenomena including PLP and other amputation-related information in a sample of 3,374 unilateral upper and lower limb amputees. Clinical and demographic variables (age at amputation, level of amputation) explained 10.6% of the variance in PLP and perceptual variables (intensity of phantom limb sensation [PLS], referred sensations, intensity of telescoping, residual limb pain [RLP] intensity) explained 16.9% of the variance. These variables were specific for PLP and not for RLP. These results suggest that distinct variables are associated with PLP (age at amputation, level of amputation, PLS intensity, referred sensations, intensity of telescoping, RLP intensity) and RLP (PLP intensity) and point at partly different mechanisms for the emergence and maintenance of PLP and RLP. PERSPECTIVE: Clinical/demographic variables as well as perceptual variables are 2 major components related to PLP and explain ∼11% and ∼17% of the variance. These results could potentially help clinicians to understand which factors may contribute to chronic phantom limb pain.

摘要

幻肢痛(PLP)是肢体截肢后的常见后果,会给患者带来严重损害。先前的研究表明,截肢时的年龄或截肢部位等多种因素与幻肢痛的出现和持续存在有关。在这项横断面研究中,我们在3374名单侧上肢和下肢截肢者的样本中评估了包括幻肢痛在内的几种幻肢现象以及其他与截肢相关的信息。临床和人口统计学变量(截肢时的年龄、截肢水平)解释了幻肢痛方差的10.6%,而感知变量(幻肢感觉[PLS]的强度、牵涉性感觉、套叠感的强度、残肢痛[RLP]强度)解释了方差的16.9%。这些变量是幻肢痛所特有的,而非残肢痛所特有。这些结果表明,不同的变量与幻肢痛(截肢时的年龄、截肢水平、PLS强度、牵涉性感觉、套叠感的强度、RLP强度)和残肢痛(幻肢痛强度)相关,并指出幻肢痛和残肢痛出现及持续存在的机制部分不同。观点:临床/人口统计学变量以及感知变量是与幻肢痛相关的两个主要组成部分,分别解释了约11%和约17%的方差。这些结果可能有助于临床医生了解哪些因素可能导致慢性幻肢痛。

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