Gary Cyril S, Horowitz Max E, Giladi Aviram M
The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC.
J Hand Surg Glob Online. 2022 Feb 10;5(1):116-120. doi: 10.1016/j.jhsg.2022.01.004. eCollection 2023 Jan.
Hand surgery patients often experience chronic pain conditions. However, there are few reliable ways to measure pain, making diagnosis and subsequent management of these conditions notably challenging for the hand surgeon. Various diagnostic biomarkers have been actively studied in the chronic pain management field with promising results. This review discusses the development of diagnostic biomarkers for chronic pain conditions of the upper extremity, including complex regional pain syndrome, osteoarthritis, and neuropathic pain. Techniques involving the measurements of heart rate variability, molecular biomarkers including inflammatory and noninflammatory molecules, metabolites, and exosomes, magnetic resonance imagining and electroencephalography, as well as skin biopsy, are discussed. Future potential applications are proposed.
手部手术患者常经历慢性疼痛状况。然而,测量疼痛的可靠方法很少,这使得手部外科医生对这些病症的诊断及后续治疗极具挑战性。在慢性疼痛管理领域,人们积极研究了各种诊断生物标志物,并取得了可喜成果。本综述讨论了上肢慢性疼痛病症诊断生物标志物的发展,包括复杂性区域疼痛综合征、骨关节炎和神经性疼痛。文中讨论了涉及心率变异性测量的技术、包括炎症和非炎症分子在内的分子生物标志物、代谢物和外泌体、磁共振成像和脑电图,以及皮肤活检。还提出了未来的潜在应用。