慢性术后内疼痛的管理
1Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
The Surgical clinics of North America
|September 14, 2023
概括
慢性术后 inguinal 疼痛 (CPIP) 影响到 15% 的患者在手术后. 管理包括诊断,非手术治疗和手术选择,如神经切除术,如果初始疗法失败.
科学领域:
- 疼痛医学 医学 疼痛医学
- 外科手术的结果
- Hernia 修复 椎间板裂的修复
背景情况:
- 慢性术后 inguinal 疼痛 (CPIP) 影响 10-15% 在美国每年大约700,000次 inguinal 手术中.
- CPIP提出了需要全面评估的诊断挑战.
- 有效的管理策略对于患者的生活质量至关重要.
研究的目的:
- 概述CPIP的诊断方法.
- 审查CPIP的非手术和手术治疗选择.
- 为临床医生提供一个管理框架.
主要方法:
- 对CPIP的诊断和治疗策略的文献综述.
- 分析当前的非手术疗法 (药物,物理疗法,干预性疼痛管理,认知疗法).
- 评估手术干预 (神经切除术,网切除).
主要成果:
- 彻底的病史,检查,差异诊断和成像是诊断CPIP的关键.
- 首先应该探索非手术疗法.
- 当保守治疗失败时,神经切除和网切除可以有效.
结论:
- CPIP是 inguinal hernia 修复的一个显著并发症.
- 一个逐步的方法,将准确的诊断与定制的非手术和手术治疗相结合,是必不可少的.
- 对最佳CPIP管理进行进一步的研究是有必要的.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
112
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
112
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Appendicitis-II: Diagnostic Studies and Management
98
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
98
Urinary Tract Calculi VI: Surgical Management
10
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
10
Inflammatory Bowel Disease V: Surgical Management
167
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
167


