战伤疼痛等级评估与镇痛策略  

Pain assessment of war wounds and analgesic strategies

作　　者：陈艳[1] 马丽[2] 孙丽君[1] 李秀敏 CHEN Yan;MA Li;SUN Lijun;LI Xiumin(Department of Pharmacy,Medical Supplies Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Anesthesiology,the Seventh Medical Centre,Chinese PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院医疗保障中心药剂科,北京100853 [2]解放军总医院第七医学中心麻醉科,北京100700

出　　处：《军事医学》2024年第8期620-624,共5页Military Medical Sciences

基　　金：新型医疗急救与镇痛需求论证(LB2023B010100)。

摘　　要：疼痛是五大生命体征之一,是战创伤伤员最主要的并发症,镇痛是战伤救治的重要内容。美军《战术战伤救治指南》明确了分级镇痛药物的使用策略。该文综述了疼痛等级评估路径,包括根据伤类伤情初步评判、主观感受量化评估和客观监测量化评估疼痛等级,分析了常用的镇痛策略,镇痛药物包括局部麻醉药、非甾体镇痛药、阿片类、N-甲基-D-天冬氨酸受体拮抗剂等,镇痛技术包括区域神经阻滞、神经射频、神经毁损、脊髓电刺激技术等,为我军完善疼痛管理手段,提升战伤救治能力提供了有益参考。Pain is one of the five vital signs,and the leading complication of war trauma,so analgesia is critical to combat casualty care.The U.S.Tactical Combat Casualty Care guidelines have defined the battlefield graded analgesic strategies.This paper reviews the assessment of pain grade of war wounds,involving the preliminary evaluation according to categories and conditions of trauma,and the quantitative evaluation according to subjective feeling and objective index monitoring.The analgesic strategies are analyzed,involving such as analgesic drugs local anesthetics,non-steroidal analgesics,opioids,N-methyl-D-aspartate receptor antagonists,and such analgesic techniques as regional nerve block,nerve radiofrequency,nerve ablation and spinal cord electrical stimulation technology.This review is expected to provide a useful reference for improving pain management and war injury treatment in China's army.

关 键 词：战伤救治 疼痛评估 镇痛策略 

分 类 号：R614[医药卫生—麻醉学]