在紧急情况下的神经病痛:诊断和管理
Pietro Emiliano Doneddu1,2, Umberto Pensato2,3, Alessandra Iorfida2,4
1Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy.
Journal of clinical medicine
|September 28, 2023
概括
神经病变性疼痛,一种灼热或类似冲击的疾病,现在在20%的急诊室访问中被观察到. 识别其独特的症状对于有效的紧急护理和治疗至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 神经学 神经学
- 疼痛管理 疼痛管理
背景情况:
- 神经病痛越来越多地出现在急诊室 (ED),占与疼痛有关的访问的20%左右.
- 传统的治疗方法往往失败,促使患者寻求紧急治疗严重的持续性疼痛.
- 在ED中确切的诊断是具有挑战性的,但对于适当的患者管理至关重要.
研究的目的:
- 概述与急诊医生相关的神经病痛的主要临床表现.
- 强调记录病史和体检在诊断神经病痛时的重要性.
- 突出需要专门的ED指导方针用于神经病痛管理.
主要方法:
- 对常见的神经病痛表现的审查,导致ED访问.
- 讨论紧急医生的诊断挑战和策略.
- 强调患者报告的症状,如灼热或类似冲击的感觉.
主要成果:
- 神经病变性疼痛通常呈现为灼热或类似冲击的感觉,对标准止痛药 (黄,NSAIDs) 没有反应.
- 现在相当一部分ED疼痛表现归因于神经病痛.
- 有效的ED管理需要有针对性的病史和体检.
结论:
- 紧急医生必须擅长识别神经病痛的疼痛表现.
- 多学科合作是制定量身定制的ED指南的关键.
- 及时识别和适当的初始管理可以改善患者的治疗结果.
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