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在上肢截肢后症状性神经瘤的周围神经外科手术中使用的结局测量指标:范围综述。

Outcome measures used in peripheral nerve surgery for symptomatic neuroma in upper extremity amputations: A scoping review.

机构信息

Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Muscle Nerve. 2024 Nov;70(5):903-915. doi: 10.1002/mus.28231. Epub 2024 Aug 13.

Abstract

Novel surgical treatments for painful neuromas are increasingly used, but determining which provides the greatest benefit has been difficult due to the inconsistent use of outcome measures. We mapped the current literature of outcome measures used to evaluate peripheral nerve surgery for the management of symptomatic neuromas in patients who underwent an adult-acquired upper extremity amputation (UEA). Medline, Embase, Cochrane, and CINAHL were searched for primary research written in the English language from inception to February 2023. The search yielded 1137 articles, of which 35 were included for final analysis. Studies varied in their assessment of pain, health-related quality of life (HRQOL), neurotrophic measures, psychological and sensorimotor function, highlighting a consensus on crucial domains but also revealing significant heterogeneity in the use and application of outcome measures among primary studies. Our findings highlight the need to establish common standards that reflect the best evidence and unique needs of the UEA population. This includes developing a core outcome set, utilizing multi-center trials, and maintaining flexibility to adapt to ongoing advancements in patient-reported outcome measures (PROMs) research.

摘要

新兴的用于治疗疼痛性神经瘤的手术治疗方法越来越多地被应用,但由于在使用结局测量指标方面的不一致性,很难确定哪种方法的获益最大。我们对用于评估成人上肢截肢(UEA)后因症状性神经瘤而行外周神经手术的患者的结局测量指标的现有文献进行了系统综述。检索了从建库至 2023 年 2 月发表的英文原始研究,检索数据库包括 Medline、Embase、Cochrane 和 CINAHL。检索共得到 1137 篇文章,其中 35 篇纳入最终分析。研究在疼痛、健康相关生活质量(HRQOL)、神经营养指标、心理和感觉运动功能方面的评估各不相同,这突出了在主要研究中对关键领域的共识,但也显示了在结局测量指标的使用和应用方面存在显著的异质性。我们的研究结果强调了需要制定反映最佳证据和 UEA 人群独特需求的共同标准。这包括制定核心结局集、利用多中心试验,并保持灵活性以适应患者报告结局测量(PROMs)研究的不断进展。

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