准则编号 准则编号 445:慢性盆腔疼痛的管理
Catherine Allaire1, Paul J Yong1, Krisztina Bajzak2
1Vancouver, BC.
概括
在女性中有效的慢性盆腔疼痛管理需要跨学科,生物心理社会方法. 这包括解决中央敏感化问题,并整合疼痛教育,理疗,心理和医疗治疗,以获得最佳的结果.
科学领域:
- 疼痛医学 医学 疼痛医学
- 妇科 妇科医生 妇科
- 康复 康复 康复 康复
背景情况:
- 慢性盆腔疼痛 (CPP) 影响青少年和成年女性,呈现复杂的多因素贡献者.
- 了解中央敏感性和鼻膜性疼痛对于有效的CPP管理至关重要.
- 现有文献强调,需要为CPP制定全面的,基于证据的指导方针.
研究的目的:
- 为管理女性慢性骨盆疼痛提供基于证据的建议.
- 制定专门针对青少年和成年女性的指导方针,不包括男性的骨盆疼痛和生殖器疼痛.
- 为CPP管理提供跨学科,生物心理社会方法的信息.
主要方法:
- 在Medline和Cochrane数据库 (1990-2020年) 中系统地搜索CPP诊断和管理的英语文章.
- 包括研究重叠的疼痛状况,中心敏感化和各种治疗方式的研究.
- 委员会以共识为基础制定建议,使用推评估,开发和评价 (GRADE) 方法对证据质量和推强度进行分级.
主要成果:
- 管理应该整合多因素的贡献者,包括中央敏感性/nociplastic疼痛.
- 建议采用跨学科的生物心理社会方法,包括疼痛教育,物理治疗以及心理和医疗治疗.
- 建议涉及诊断,重叠的疼痛状况和各种治疗干预措施.
结论:
- CPP管理需要采用整体方法,考虑生物,心理和社会因素.
- 涉及疼痛教育,物理治疗和心理/医学治疗的跨学科护理是关键.
- 基于证据的建议旨在通过指导医疗保健专业人员在CPP管理中改善患者的治疗结果.
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