用神经切除术和皮肤感官外周神经接口治疗的乳腺切除术后疼痛综合征:改善疼痛和阿片类药物的使用
Geoffrey E Hespe1, Michael N Saunders2, Jennifer B Hamill1
1Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI.
Plastic and reconstructive surgery
|November 25, 2025
概括
用皮肤感觉外围神经接口 (DSPNI) 进行神经切除术显著减少神经病性乳腺切除后疼痛综合征 (nPMPS). 这种手术干预还可以降低患者的相关焦虑,抑郁和阿片类药物依赖.
科学领域:
- 疼痛管理中的外科创新.
- 神经学和瘤外科手术.
背景情况:
- 神经性乳房切除术后疼痛综合征 (nPMPS) 是乳房手术的常见,使人衰弱的并发症.
- 目前针对nPMPS的手术治疗算法尚未得到充分的研究.
研究的目的:
- 评估神经切除术与皮肤传感外围神经接口 (DSPNI) 在管理nPMPS.的有效性.
- 评估DSPNI对减轻疼痛和相关并发症的影响.
主要方法:
- 一项前性,单中心的队列研究,涉及20名患有nPMPS的患者.
- 患者在2019年7月至2023年4月期间接受了DSPNI的神经切除术.
- 患者报告的结果和临床数据是在手术前后收集的.
主要成果:
- 在神经切除术后观察到疼痛得分 (NPRS,SF-MPQ-2,PROMIS) 的显著降低.
- 在患者报告结果测量信息系统 (PROMIS) 底值中观察到的改善是强度,疼痛干扰和神经病痛.
- 记录了阿片类药物使用的减少,每日口服吗啡相当量,以及抑郁症 (PHQ-9) 和焦虑症 (GAD-7) 的得分.
结论:
- 用DSPNI进行神经切除是慢性nPMPS的安全有效治疗方法.
- 该程序显著缓解疼痛,焦虑和抑郁.
- 在患有nPMPS的患者中,DSPNI减少了对阿片类止痛药的依赖.
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