顽固性下肢缺血性疼痛的多模式镇痛治疗  

Multimodal analgesia for intractable lower limb ischemic pain

作　　者：刘华波 张众 赵彩红 王忠岳 陶高见[2] 

机构地区：[1]浙江舟山医院疼痛科,浙江舟山316000 [2]南京大学医学院附属南京鼓楼医院疼痛科,江苏南京316012

出　　处：《中国生化药物杂志》2017年第5期394-396,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：浙江省舟山市科技计划项目(编号2012C13020)

摘　　要：目的观察以腰交感神经毁损联合全身和局部用药对顽固性下肢缺血性疼痛的疗效。方法 21例顽固性下肢缺血性疼痛患者接受腰交感神经毁损,同时在足部局部外用扶他林乳胶剂并根据情况联合使用抗惊厥类药物和阿片类药,观察和评估患者治疗前后静息疼痛视觉模拟评分（visual analogue scale,VAS）,局部皮肤温度。结果行腰交感神经阻滞及局部外用扶他林乳胶剂后,21例患者疼痛均有缓解。综合治疗后有2例患者效果不佳,其余19例患者疼痛缓解至VAS〈3,其中有4例患者基本不需要全身应用镇痛药物,其余患者需全身应用镇痛药物。结论对顽固性下肢缺血性疼痛宜采取多模式综合治疗。Objective To observe the curative effect of lumbar sympathetic nerve injury combined with systemic and local medication in intractable lower limb ischemic pain.Methods21 patients with intractable lower limb ischemic pain accepted lumbar sympathectomy,at the same time foot topical Votalinemulgel used and Combined with anticonvulsants and opioids according to circumstances,the visual analogue scale of resting pain（visual analogue scale,VAS）,the Local skin temperaturebefore and after treatment were observed and evaluated.ResultsAfter Lumbar sympathetic nerve block and topical Votalinemulgel,21 patients had pain relief.After treatment, 2 patients had poor effect,the remaining 19 patients had pain relief to VAS〈3, 4 patients did not need systemic analgesic drugs,the rest of the patients need systemic analgesic drugs.ConclusionIt is necessary to adopt multimodal comprehensive treatment for intractable lower limb ischemic pain.

关 键 词：缺血性疼痛 多模式镇痛 腰交感神经毁损 局部用药 非甾体类药物 阿片类药物 

分 类 号：R614[医药卫生—麻醉学]