截肢后疼痛管理。

Postamputation Pain Management.

机构信息

Department of Physical Medicine & Rehabilitation, Greater Los Angeles Veteran Affairs HealthCare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Division of PM&R, Department of Medicine, 200 UCLA Medical Plaza, Suite 420, Los Angeles, CA 90095, USA.

出版信息

Phys Med Rehabil Clin N Am. 2024 Nov;35(4):757-768. doi: 10.1016/j.pmr.2024.06.003. Epub 2024 Jul 16.

DOI:10.1016/j.pmr.2024.06.003

PMID:39389635

Abstract

Postamputation pain is one of the most common and challenging pain conditions to treat and includes residual limb pain and phantom limb pain. Residual limb pain is present at the amputation site or proximal to the amputation site and may be caused by poor wound healing, poor prosthetic fitting, or neuropathic pain. Phantom limb pain is experienced distal to the amputation site and may be caused by maladaptive supraspinal reorganization. Treatment for post amputation pain should be multimodal and multidisciplinary, including pharmacologic agents, rehabilitation, psychosocial support, and integrative therapies. Surgical interventions including neuromodulation may be considered for refractory cases.

摘要

截肢后疼痛是最常见和最具挑战性的疼痛病症之一，包括残肢痛和幻肢痛。残肢痛位于截肢部位或截肢部位附近，可能由伤口愈合不良、假肢适配不良或神经病理性疼痛引起。幻肢痛发生在截肢部位的远端，可能由适应性中枢神经系统重组引起。截肢后疼痛的治疗应采用多模式和多学科方法，包括药物治疗、康复、心理社会支持和综合治疗。对于难治性病例，可考虑手术干预，包括神经调节。