Houghton A D, Nicholls G, Houghton A L, Saadah E, McColl L
Department of Surgery, Guy's Hospital, London.
Ann R Coll Surg Engl. 1994 Jan;76(1):22-5.
All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. Of these, 98 amputations were performed for trauma and 78 for vascular disease. Below-knee amputees rehabilitated better than above-knee amputees (P < 0.05) and traumatic better than vascular amputees (P < 0.0001). Preoperative pain was worse in vascular amputees (P < 0.0005), but there was no significant difference in the amount of phantom-pain experienced by vascular and traumatic amputees. Phantom sensations were experienced by 82% and phantom pain by 78%. Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.
一家残疾服务中心所照料的全部338名下肢截肢者被要求评估截肢后不同时间的幻肢痛严重程度。在212份（63%）回复中，13人已去世，22人未佩戴假肢，22人无法完成问卷。总共收到176份有效回复——96例膝下截肢、74例膝上截肢和6例膝间截肢。其中，98例截肢是因创伤进行的，78例是因血管疾病进行的。膝下截肢者比膝上截肢者康复得更好（P<0.05），创伤性截肢者比血管性截肢者康复得更好（P<0.0001）。血管性截肢者术前疼痛更严重（P<0.0005），但血管性截肢者和创伤性截肢者所经历的幻肢痛程度没有显著差异。82%的人有幻肢感觉，78%的人有幻肢痛。幻肢痛随时间减轻，在创伤性截肢者和血管性截肢者中出现的情况相同，并且与术前疼痛程度相关（P<0.005）。只有22%的人认为幻肢痛妨碍了他们的康复。康复评分与完成问卷时的幻肢痛严重程度相关（P<0.05），但与术后其他特定时间无关。
