卒中后中樞神經(jīng)痛的研究進(jìn)展
發(fā)布時(shí)間:2018-02-28 05:15
本文關(guān)鍵詞: 腦卒中 中樞性神經(jīng)痛 綜述 出處:《重慶醫(yī)科大學(xué)》2017年碩士論文 論文類型:學(xué)位論文
【摘要】:卒中后中樞神經(jīng)痛(CPSP)是卒中后疼痛中最常見的一種中樞性神經(jīng)病理性疼痛,常發(fā)生于腦卒中后6個(gè)月內(nèi)。其發(fā)生與腦卒中部位有關(guān),在脊髓-丘腦-皮質(zhì)感覺傳導(dǎo)通路上任何部位的腦卒中均可發(fā)生CPSP,而且年齡較輕和椎基底動(dòng)脈系統(tǒng)的腦卒中患者更易發(fā)生CPSP。CPSP的發(fā)病機(jī)制尚不明確,但目前得到廣泛關(guān)注的是“中樞敏化”和“脫抑制”假說。CPSP的臨床表現(xiàn)多樣,主要與發(fā)病部位有關(guān),但主要特征是疼痛和感覺異常。疼痛呈燒灼、擠壓、針刺、寒冷、或撕裂樣,可因情緒緊張、寒冷、熱度、疲勞或身體運(yùn)動(dòng)而加劇,休息后減輕。CPSP的診斷雖有多個(gè)診斷標(biāo)準(zhǔn),但均缺乏特異性,需結(jié)合病史、體格檢查及影像學(xué)資料,并排除其他原因引起的疼痛。CPSP的治療較困難,可采用藥物、神經(jīng)調(diào)控及心理干預(yù)的綜合治療。藥物包括抗抑郁類藥物、抗驚厥類藥物、阿片類藥物及谷氨酸能藥物。精心的護(hù)理對(duì)最大限度緩解患者疼痛,提高其生活質(zhì)量具有十分重要的作用。
[Abstract]:Central nervous pain (CPSP) is the most common type of central neuropathic pain after stroke, which usually occurs within 6 months after stroke. CPSP.CPSP can occur in any part of the spinal cord thalamus-cortex sensory conduction pathway, and the pathogenesis of CPSP.CPSP is not clear in the younger stroke patients and the vertebrobasilar artery system stroke patients. However, the clinical manifestations of the "central sensitization" and "depress" hypothesis. CPSP are mainly related to the site of the disease, but the main characteristics are pain and abnormal sensation. The pain is burning, squeezing, acupuncture and cold. Or tear like, may be aggravated by emotional tension, cold, heat, fatigue or physical exercise. Although there are many diagnostic criteria for reducing .CPSP after rest, they all lack specificity and need to be combined with medical history, physical examination and imaging data. It is difficult to eliminate pain caused by other causes. CPSP can be treated with drugs, nerve regulation and psychological intervention. Drugs include antidepressants and anticonvulsants. Meticulous nursing care plays an important role in relieving pain and improving the quality of life of patients.
【學(xué)位授予單位】:重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R743.3
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