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吉兰-巴雷综合征中的神经性疼痛:与康复结局及生活质量的关联

Neuropathic Pain in Guillain-Barre Syndrome: Association with Rehabilitation Outcomes and Quality of Life.

作者信息

Swami Tripti, Khanna Meeka, Gupta Anupam, Prakash Navin B

机构信息

Department of Neurological Rehabilitation, NIMHANS, Bengaluru, Karnataka, India.

出版信息

Ann Indian Acad Neurol. 2021 Sep-Oct;24(5):708-714. doi: 10.4103/aian.AIAN_602_20. Epub 2020 Nov 7.

Abstract

BACKGROUND

Neuropathic pain contributes significantly to the morbidity and affects the quality of life adversely in Guillain-Barre syndrome (GBS).

OBJECTIVE

To study neuropathic pain profile in GBS and association with rehabilitation outcomes and effect on the quality of life.

METHODS

Observational study conducted in rehabilitation setting of a tertiary care hospital among adult GBS patients of less than 3 months duration. Assessment was done at the time of admission and discharge with Pain-detect questionnaire (PD-Q), Neuropathic pain scale (NPS), SF 36 survey, Medical Research Council (MRC) score, INCAT sensory sum score (ISS), Overall Disability sum-score (ODSS), Hughes disability score (HDS), Hospital Anxiety and Depression scale (HADS), and Fatigue Severity scale (FSS). Neuropathic pain was managed as per routine protocol and rehabilitation program was individualized.

RESULTS

32 participants (26 males) with median age of 34.50 years were included. Eighteen (56.25%) patients had neuropathic pain on PD-Q at admission. The median intensity of pain on NPS scale was 47 at admission which decreased significantly to 14 at discharge. Pain group showed significant association with sensory impairment, CSF protein, and emotional domains of QOL while no association with disability.

CONCLUSION

Neuropathic pain is associated with sensory impairment in GBS and markedly affects the quality of life, especially emotional, family, and social activities.

摘要

背景

在吉兰-巴雷综合征(GBS)中,神经性疼痛对发病率有显著影响,并对生活质量产生不利影响。

目的

研究GBS中的神经性疼痛特征及其与康复结局的关联以及对生活质量的影响。

方法

在一家三级护理医院的康复科对病程小于3个月的成年GBS患者进行观察性研究。在入院时和出院时使用疼痛检测问卷(PD-Q)、神经性疼痛量表(NPS)、SF 36调查问卷、医学研究委员会(MRC)评分、INCAT感觉总分(ISS)、总体残疾总分(ODSS)、休斯残疾评分(HDS)、医院焦虑抑郁量表(HADS)和疲劳严重程度量表(FSS)进行评估。神经性疼痛按照常规方案进行处理,康复计划则因人而异。

结果

纳入32名参与者(26名男性),中位年龄为34.50岁。18名(56.25%)患者在入院时PD-Q显示有神经性疼痛。入院时NPS量表上疼痛的中位强度为47,出院时显著降至14。疼痛组与感觉障碍、脑脊液蛋白以及生活质量的情感领域显著相关,而与残疾无关。

结论

在GBS中,神经性疼痛与感觉障碍相关,并显著影响生活质量,尤其是情感、家庭和社交活动。

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本文引用的文献

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Pain during the acute phase of Guillain-Barré syndrome.吉兰-巴雷综合征急性期的疼痛
Medicine (Baltimore). 2018 Aug;97(34):e11595. doi: 10.1097/MD.0000000000011595.
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Pain in Guillain-Barre syndrome: a long-term follow-up study.格林-巴利综合征疼痛:一项长期随访研究。
Neurology. 2010 Oct 19;75(16):1439-47. doi: 10.1212/WNL.0b013e3181f88345. Epub 2010 Sep 22.

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