Liu Qinghua, Qiu Peipei, Ma Tao, Zhao Yali, Fu Shihui, Gao Minglong, Feng Zeguo, Feng Long
Department of Anesthesiology, Xi'an Eighth Hospital, Xi'an, China.
Department of Anesthesiology, 928th Hospital of the People's Liberation Army Joint Logistics Support Force, Haikou, China.
Korean J Pain. 2025 Jul 1;38(3):222-243. doi: 10.3344/kjp.24425.
This up-to-date review focused on the recent advances in the concept, interrelationship, and mechanisms of the polytrauma clinical triad (PCT), and intervention knowledge and approaches to its prevention and treatment from the perspective of military pain medicine, hoping to provide a scientific basis and reference of PCT. Many soldiers suffering from chronic pain coexist with post-traumatic stress disorder and traumatic brain injury. If the above three diseases exist, it is called PCT. Three diseases in this common triad are interrelated and reinforce each other. This triad is challenging to treat and often leads to chronic issues, especially if not adequately monitored and managed. Although each disease of this triad could occur in isolation, it is valuable to know whether the rest of PCT needs to be screened. Current treatment of this triad emphasizes accurate identification and assessment of each disease, the new interdisciplinary and multimodal system of care, individualized customization principles, and shared medical decisions. To maximize clinical success and military service, interdisciplinary providers may benefit from the joint development of complementary treatment and biopsychosocial approach supported by theoretical and empirical evidence. The management of the PCT should emphasize integrative medicine and new interdisciplinary, multimodal nursing. Furthermore, cognitive behavioral therapy, standard rehabilitation care, and integrated health therapy have yielded valuable efficacy. It also should encourage the establishment of harmonious treatment relationships, shared medical decisions, and individualized customization principles to care for military service members with these comorbidities.
这篇最新综述聚焦于多发伤临床三联征（PCT）的概念、相互关系及机制方面的最新进展，以及从军事疼痛医学角度对其预防和治疗的干预知识与方法，以期为PCT提供科学依据和参考。许多患有慢性疼痛的士兵同时存在创伤后应激障碍和创伤性脑损伤。若上述三种疾病同时存在，则称为PCT。这个常见三联征中的三种疾病相互关联、相互强化。这一三联征治疗起来颇具挑战性，常常会导致慢性问题，尤其是在未得到充分监测和管理的情况下。虽然该三联征中的每种疾病都可能单独发生，但了解是否需要筛查PCT中的其他疾病很有价值。目前对这一三联征的治疗强调对每种疾病进行准确识别和评估、新的跨学科和多模式护理体系、个性化定制原则以及共同医疗决策。为了最大限度地提高临床成功率和军事服役能力，跨学科医疗人员可能会从在理论和实证证据支持下联合开发补充治疗和生物心理社会方法中受益。PCT的管理应强调整合医学以及新的跨学科、多模式护理。此外，认知行为疗法、标准康复护理和综合健康疗法已产生了有价值的疗效。还应鼓励建立和谐的治疗关系、共同医疗决策和个性化定制原则，以照顾患有这些合并症的军人。
