预防性向肌肉再内尔化对截肢后疼痛的有效性,在膝盖以上截肢的患者中:一项随机对照试验
Raajeshwaran M A1, Nida Mir, Sushma Sagar
1From the Division of Trauma Surgery & Critical Care (R.M.A., N.M., S.S., J.A., P.P., N.C., D.B., B.M., A.G., S.K., A.K.), JPN Apex Trauma Centre, Department of Biostatistics (M.A.K.), Department of Critical and Intensive Care (K.D.S., R.A.), JPN Apex Trauma Centre, and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India.
截肢时的向肌肉再生 (TMR) 手术显著减少残余四肢疼痛和幻肢疼痛. 这种预防性干预改善了手术后3个月的患者结果.
科学领域:
- 在肢体损失管理中的外科创新.
- 疼痛管理和神经肌肉骨研究.
背景情况:
- 截肢后的疼痛是截肢者患病的重要原因之一.
- 截肢神经的预防性手术干预显示出治疗截肢后疼痛的前景.
研究的目的:
- 分析截肢期间针对性肌肉再生 (TMR) 在解决残余四肢疼痛和幻肢疼痛方面的作用.
主要方法:
- 一项随机对照试验 (RCT) 涉及97名接受膝盖以上截肢 (AKA) 的患者.
- 患者被随机分配到TMR (干预) 或常规形 (控制) 中.
- 在48小时和12周评估的结果包括疼痛 (MPQ,PROMIS),心理健康 (HADS) 和神经解剖学 (超声波).
主要成果:
- 与对照组 (p=0.001) 相比,TMR显著降低了残余四肢疼痛 (1.8比3.3) 和幻肢疼痛 (1.2比2.6).
- 在心理评分 (HADS,MPQ,PROMIS) 中观察到有统计学意义的改善.
- 通过超声波测量的神经瘤大小在12周的TMR组显着较小 (p <0.05).
结论:
- 截肢时的预防性TMR手术有效地减少了术后残余四肢和幻肢疼痛.
- 在3个月的随访期内,TMR显示了减少疼痛和心理健康的显著益处.
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