幻肢痛发病机制及临床治疗研究

发布时间：2018-07-17 05:46

【摘要】：幻肢(phantom limb)是指某部分肢体已截去后,截肢者仍有该肢体存在的感觉。由幻肢所产生的疼痛,就叫幻肢痛(phantom limb pain,PLP)。幻肢痛的发生部位不仅局限于四肢,其他身体部位如乳房、直肠、外生殖器、牙齿、舌头、眼睛等切除时也会发生。最早提出幻肢痛这一概念的是法国的外科军医Ambrose Pare,因为他注意到截肢病人在截肢后一段时间内仍感觉到已截除的肢体疼痛。外科医生Silas Weir Mitchell在1871年首次在论文中使用“Phantom limb”幻肢一词。现有资料表明50%-80%以上的截肢患者,均伴有程度不等的幻肢痛[1-2]。统计学分析表明在幻肢痛患者中,失去工作能力占18%,工作能力受到影响占33.5%,社会能力下降明显的占43%,失眠现象占82%,日常活动受到影响占45%[3]。因此幻肢痛给患者带来无尽的痛苦[4]。近年来截肢后伴有的幻肢痛对患者的危害逐渐引起社会重视。但是到目前为止幻肢痛的发病机制仍未完全阐明,治疗上也非常困难。本文就从幻肢痛的主要表现、发病机制以及临床治疗研究作一综述。
[Abstract]:Phantom limb (phantom limb) means that the amputee still has the feeling of amputation after the limb has been amputated. The pain caused by the phantom limb is called the phantom limb pain (phantom limb. Phantom limb pain occurs not only in the extremities, but also in other parts of the body such as the breast, rectum, genitals, teeth, tongue, and eyes. The concept of phantom limb pain was first proposed by the French surgeon Ambrose Parehe because he noticed that the amputee still felt the amputated limb pain for some time after amputation. Surgeon Silas Weir Mitchell first used the term "Phantom limb" in his paper in 1871. Available data show that 50-80% of amputation patients with varying degrees of phantom limb pain [1-2]. Statistical analysis showed that in patients with phantom limb pain, loss of working ability accounted for 18%, work ability affected 33.5%, social ability decreased significantly (43.3%), insomnia accounted for 82%, daily activities affected 45% [3]. Therefore, phantom limb pain brings endless pain to patients [4]. In recent years, the harm to patients caused by phantom limb pain after amputation has been paid more and more attention. But so far, the pathogenesis of phantom limb pain has not been fully elucidated, and treatment is very difficult. This article reviews the main manifestations, pathogenesis and clinical treatment of phantom limb pain.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.99

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