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乳房切除术后疼痛的介入治疗选择。

Interventional Treatment Options for Post-mastectomy Pain.

机构信息

Department of Physical Medicine and Rehabilitation Medicine, Emory University School of Medicine, 1441 E Clifton Rd NE, Atlanta, GA, 30322, USA.

Department of Rehabilitation Medicine, Oncology Rehabilitation Medicine, Winship Cancer Institute of Emory University, 1365 Clifton Rd Building C, Atlanta, GA, 30322, USA.

出版信息

Curr Oncol Rep. 2023 Oct;25(10):1175-1179. doi: 10.1007/s11912-023-01435-z. Epub 2023 Aug 30.

Abstract

PURPOSE OF REVIEW

Breast cancer is currently the most prevalent cancer diagnosed globally, and there is a significant gap in the availability of effective first-line treatment options. In addition to a cancer diagnosis, breast cancer patients face additional pain and morbidity after treatment. Radiation fibrosis, muscle spasms, muscle pain, neuropathy, and limited shoulder function are all potential side effects of breast cancer treatment and breast reconstruction. Post-mastectomy pain syndrome affects 25-60% of people after breast surgery. The current review moves forward to explain interventional pain management options that can be used to supplement conservative measures (physical therapy, medication, topical ointments) to help these patients.

RECENT FINDINGS

There are many new interventional procedures to treat chest wall pain, neuropathic pain, and spasticity after breast surgery. Currently, the most commonly performed procedures are botulinum toxin injections, serratus anterior plane blocks, intercostobrachial nerve blocks, thoracic paravertebral nerve blocks, pectoralis nerve blocks, and erector spinae nerve blocks. Utilizing one of these interventional procedures, along with physical therapy and pharmacologic interventions, can help manage post-mastectomy pain syndrome in the millions of breast cancer patients diagnosed and treated every year.

摘要

目的综述

乳腺癌是目前全球最常见的诊断癌症,在有效一线治疗方案的可及性方面存在显著差距。除癌症诊断外,乳腺癌患者在治疗后还面临额外的疼痛和发病。放射纤维化、肌肉痉挛、肌肉疼痛、神经病变和肩部功能受限都是乳腺癌治疗和乳房重建的潜在副作用。乳房手术后疼痛综合征影响 25-60%的人。本综述进一步解释了介入性疼痛管理的选择,这些选择可用于补充保守措施(物理治疗、药物、局部软膏),以帮助这些患者。

最近的发现

有许多新的介入性程序可用于治疗乳房手术后的胸壁疼痛、神经性疼痛和痉挛。目前,最常进行的程序是肉毒杆菌毒素注射、前锯肌平面阻滞、肋间臂神经阻滞、胸椎旁神经阻滞、胸大肌神经阻滞和竖脊肌神经阻滞。利用这些介入性程序之一,结合物理治疗和药物干预,可以帮助每年诊断和治疗的数百万乳腺癌患者管理乳房手术后疼痛综合征。

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