幻肢痛:当前的概念和治疗策略

María Alejandra Nieto‐Salazar
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引用次数: 0

摘要

幻肢综合征(Phantom limb syndrome, PLS)被描述为源于截肢或其他缺失肢体的感觉感知[1]。尽管肢体不存在,但患者可能会经历各种感觉和运动感觉,就好像肢体仍然存在一样。幻肢症状包括一系列感觉,包括缺失肢体的存在、脚趾摆动或手的开合、压力、刺痛、瘙痒、温度变化和疼痛等运动[1-3]。幻肢痛(PLP)在这些患者中很常见,其强度、持续时间和质量各不相同,从悸动或刺痛到灼烧或痉挛的感觉。由于评估的时间窗不同,患病率研究的统计异质性很高[4-10]。然而,据估计,大约60-80%的截肢患者可能会有幻肢感觉,其中约50-85%的患者可能还会有幻肢疼痛[11,12]。有几个因素已被确定为发生这种类型疼痛的潜在危险因素,包括截肢程度、先前存在的疼痛、截肢后疼痛、慢性疼痛史和心理因素(即焦虑、抑郁、创伤后应激障碍)[12,13]。
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Phantom Limb Pain: Current Concepts and Treatment Strategies
Phantom limb syndrome (PLS) is described as the perception of feelings originating from a limb that has been amputated or is otherwise absent [1]. Despite this physical absence, patients may experience various sensory and motor sensations as if the limb were still present. Phantom limb symptoms encompass a range of sensations, including the missing limb's presence, movements such as wiggling toes or opening and closing the hand, pressure, tingling, itching, temperature changes, and pain [1-3]. Phantom limb pain (PLP) is commonly encountered in these patients, and it can vary in intensity, duration, and quality, ranging from throbbing or stabbing sensations to burning or cramping feelings. There is a high statistical heterogeneity across prevalence studies due to the different time windows assessed [4-10]. However, it is estimated that approximately 60-80% of individuals who have undergone limb amputation may experience phantom limb sensations, and around 50-85% of those individuals may also experience phantom limb pain [11,12]. Several factors have been identified as potential risk factors for developing this type of pain, including the level of amputation, pre-existing pain, post-amputation pain, chronic pain history, and psychological factors (i.e., anxiety, depression, post-traumatic stress disorder) [12,13].
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