摘要
近年来越来越多的研究表明手术后容易出现慢性疼痛,经历胸科手术的患者中约25%~60%会发展成为慢性疼痛(chronic postsurgical pain,CPSP)。CPSP已经成为影响患者术后生存质量的一个严重的问题。胸科手术术后CPSP产生原因十分复杂,炎症反应和神经继发性的炎症或损伤所引起的外周或者中枢敏化是导致疼痛慢性化的主要病理机制。术前、术中、术后多种因素均可以导致痛觉敏化。术后CPSP一旦出现,治疗起来十分困难。目前胸科手术术后CPSP的治疗和预防策略当中,多数专家认为早期的预防性干预能大大降低术后CPSP的发生率。本文就胸科手术术后CPSP的发生机制、高危因素、预防和治疗策略进行详细论述。
In recent years,more and more studies have shown that chronic pain tends to occur after surgery,and about 25%~60%of patients undergoing chest surgery will develop into chronic postsurgical pain(CPSP).CPSP has become a serious problem affecting the postoperative life quality of patients.The causes of CPSP are complex,inflammatory response and peripheral or central sensitization caused by secondary inflammation or injury of the nerve are the main pathological mechanisms.Pre-operative,intra-operative and post-operative factors can lead to pain sensitization.Once CPSP develops,treatment is fairly difficult.Among the current treatment and prevention strategies for CPSP after chest surgery,most experts believe that early preventive intervention can greatly reduce the incidence of CPSP.In this review,we will comprehensively discuss the pathological mechanisms,highrisk factors and strategies of prevention and treatment of CPSP after thoracic surgeries.
作者
扶超
胡渤
屠伟峰
FU Chao;HU Bo;TU Weifeng(Department of Anesthesiology,General Hospital of Southern Theater Command,The First School of Clinical medicine,Southern Medical University,Guangzhou 510010,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第24期3725-3730,共6页
The Journal of Practical Medicine
基金
广东省自然科学基金项目(编号：2014A030311012)
关键词
胸科术后慢性疼痛
发病机制
高危因素
治疗
预防
chronic pain after thoracic operation
pathological mechanisms
high-risk factors
treatment
strategies of prevention
