产后刺痛头痛的病因学,管理和后果
Daniel Taraskiewicz1, Jessica Sheeran, Paul De Marco
1Department of Anesthesiology, University of Virginia, School of Medicine, Hospital of the University of Virginia, Virginia, USA.
Current opinion in anaesthesiology
|August 8, 2023
概括
产后刺痛头痛 (PDPH) 可能与可修改的风险因素并不像以前认为的那样相关. 虽然外周周围血贴是标准的,但新的治疗方法对轻度至中度的PDPH有前途,尽管长期问题的风险仍然存在.
科学领域:
- 麻醉学 麻醉学
- 神经学 神经学
- 疼痛管理 疼痛管理
背景情况:
- 持续性穿刺后头痛 (PDPH) 是经历持续性穿刺后的一种已知的并发症.
- 最近的研究重点是改进对风险因素,治疗和后果的理解,特别是长期影响.
研究的目的:
- 提供PDPH的原因,发病率,治疗方法和后果的简要概述.
- 总结最近关于可修改的风险因素,治疗干预措施和硬膜穿刺的长期结果的研究结果.
主要方法:
- 审查最近的元分析和临床试验.
- 对PDPH风险因素和治疗疗效的新兴数据的分析.
- 评估对长期穿刺的短期和长期后果的研究.
主要成果:
- 对PDPH的可修改风险因素可能并不像以前认为的那样绝对.
- 一些新的元分析和临床试验提供了关于有效PDPH疗法的数据.
- 显著的新数据突出显示了长期持续性穿刺的长期后果.
结论:
- 针类型和尺寸可能不会影响低风险患者的PDPH发展.
- 虽然外周周周血贴 (EBP) 是黄金标准,但替代医学和程序干预措施对轻度至中度的PDPH有希望.
- 经历持续刺痛的患者,特别是意外持续刺痛 (ADP),面临短期问题和慢性疼痛的低但显著风险.
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