慢性疼痛综合征: 慢性神经病性疼痛 慢性神经病性疼痛
1Department of Family Medicine - F. Edward Hébert School of Medicine - Uniformed Services University of the Health Sciences, Bethesda, MD.
FP essentials
|October 9, 2023
概括
神经病痛,影响高达10%的人,源于神经系统损伤. 管理涉及临床判断,感官症状评估和从药物到疗法的一系列治疗.
科学领域:
- 神经学 神经学
- 疼痛医学 医学 疼痛医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 神经病痛影响7-10%的人口,显著降低生活质量.
- 定义为体感神经系统病变 (中央或外围) 的疼痛.
- 诊断往往依赖于临床判断,因为测试结果的变化.
研究的目的:
- 概述神经病痛的特征和管理策略.
- 为了区分神经病痛与其他慢性疼痛疾病.
- 审查目前神经病痛治疗的治疗选择.
主要方法:
- 临床评估和患者病史.
- 使用问卷和评分系统进行诊断.
- 对药物治疗和非药物治疗治疗选择的审查.
主要成果:
- 神经病痛呈现出明显的感官症状,如灼伤或麻木.
- 管理具有挑战性,往往需要采用多式联运方式.
- 第一线治疗包括局部药物, gabapentinoids,TCA和SNRIs;特拉马多尔是二线的.
- 非药物治疗选择和心理治疗转诊是有价值的辅助.
- 在耐火病例中考虑程序干预和阿片类药物.
结论:
- 有效的神经病痛管理需要一个全面的方法.
- 早期识别特征性感官症状至关重要.
- 建议采取逐步的治疗策略,从一线药物到先进的干预措施.
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