三胞胎神经疼痛的管理:在全科医院的多中心病例研究
Zofia J Zakrzewska1, Parinaz Hosseini-Ashrafi2, Ishrat Hussain3
1Portsmouth Hospitals NHS Trust, Portsmouth, UK.
British journal of pain
|November 17, 2023
概括
在英国,三神经疼痛 (TN) 的患病率可能被低估,许多患者在初级保健中不符合诊断标准. 这项研究强调了潜在的诊断缺失和低于最佳的管理,影响了患者的护理.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 主要护理医学 医疗保健
背景情况:
- 在初级保健中,三神经疼痛 (TN) 的诊断和管理往往缺乏遵守指南.
- 英国最新的TN流行数据很少.
- 初级保健医生经常是TN症状患者的第一个接触点.
研究的目的:
- 在英国估计三神经疼痛 (TN) 的患病率.
- 审计初级保健机构中TN的诊断和管理.
- 评估对TN的诊断标准和治疗指南的遵守情况.
主要方法:
- 2019年至2020年期间,从五家英国全科医生 (GP) 诊所 (总人口55842) 进行了对患者记录的回顾性审查.
- 使用EMIS和SystmOne系统识别患有三神经疼痛 (TN) 或面部疼痛 (FP) 的患者.
- 对诊断基础,初级保健管理和二级保健转诊模式的分析.
主要成果:
- 据估计,TN的患病率为每10,000人中有22.3人.
- 只有7名患者符合所有诊断标准,其中2名确诊为TN.
- 卡巴马西平被处方给了58.8%的TN患者,38.2%被转诊给专家.
结论:
- 事实上,TN的实际患病率可能比之前报告的要高.
- 忽略关键诊断标准是常见的,可能导致误诊或延迟诊断.
- 对于TN患者的转诊率很低,尽管建议考虑成像.
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