提高对慢性腹痛-腹壁痛的认识与诊治水平  

Raising Awareness of Chronic Abdominal Wall Pain for Optimizing the Diagnosis and Treatment

作　　者：王娜[1] 姬翠英 白研[2] 白文元[1] WANG Na;JI Cuiying;BAI Yan;BAI Wenyuan(Department of Gastroenterology,the Second Hospital of Hebei Medical University,Shijiazhuang,050000;Department of Oncology, the Third Hospital of Hebei Medical University, Shijiazhuang)

机构地区：[1]河北医科大学第二医院消化内科,050000 [2]河北医科大学第三医院肿瘤科

出　　处：《胃肠病学》2019年第11期641-644,共4页Chinese Journal of Gastroenterology

摘　　要：慢性腹壁痛是门诊和住院患者常见且易被忽视的慢性腹痛病因,常见于中年人,女性比男性更为多见。慢性腹壁痛是由于支配腹壁的感觉神经皮肤分支感觉异常所致。尽管可通过病史询问、体格检查和触痛点局部注射进行诊断,但患者在确诊前常需接受相关实验室、影像学等检查,且常被误诊。Carnett体征有助于区别腹部疼痛是源自腹壁还是腹部内脏。治疗主要包括生活方式改变、非处方止痛剂和触痛点局部注射,极少数情况下可能需使用化学神经松解术或神经切除术。Chronic abdominal wall pain is a common,yet often overlooked,cause of chronic abdominal pain in both outpatient and inpatient settings.This disorder most commonly affects middle-aged adults and is more prevalent in women than in men.In chronic abdominal wall pain,the pain occurs due to entrapment of cutaneous branches of the sensory nerves that supply the abdominal wall.Although the diagnosis of chronic abdominal wall pain can be made by patient’s history,physical examination,and response to trigger point injection,patients often undergo extensive and exhaustive laboratory,imaging,and procedural work-up before being diagnosed as abdominal wall pain and are often misdiagnosed.Carnett’s sign is helpful for differentiating the pain originated from the abdominal wall or from the abdominal viscera.The mainstay of treatment consists of change of life style,over-the-counter analgesic agent,and trigger point injection.In rare cases,chemical neurolysis or surgical neurectomy might be required.

关 键 词：腹壁痛 腹痛 诊断 诊断 鉴别 治疗 Carnett体征 

分 类 号：R73[医药卫生—肿瘤]