截肢后幻肢痛的综合康复治疗  

Complex rehabilitative treatment on the phantom limb pain after amputation

作　　者：汪琴[1] 吴杰凤[1] 冯莉[1] 陈蕾[1] 刘宏亮[1] 

机构地区：[1]解放军第三军医大学西南医院康复科,重庆市400038

出　　处：《中国临床康复》2004年第8期1408-1409,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨以药物为主的综合疗法治疗截肢后幻肢痛的效果。方法:对13例伴有幻肢痛的截肢患者采用三环类抗抑郁药阿米替林和抗癫痫药卡马西平,并配合心理支持治疗,针灸,经皮神经电刺激(TENS)、石蜡疗法、运动疗法等物理疗法进行治疗,用视觉模拟评分法(VAS)、ZUNG抑郁状态自评量表(SDS)于治疗前后对幻肢痛及抑郁状态进行评定。结果:治疗后患者疼痛的强度有显著性降低(P<0.01,t=39.08),患者抑郁评分与治疗前相比也有显著性降低(P<0.01,t=15.55)。结论:采取综合疗法治疗幻肢痛是切实有效的,并初步探讨了其作用的可能机制。AIM:To explore the effects of complex treatment dominated by drugs on the phantom limb pain after amputation. METHODS:A total of 13 cases of amputee with phantom limb pain were treated by drugs(amitriptyline and carbamazepine) combined with psychological support,acupuncture therapy,transcutaneous electrical nerve stimulation(TENS),paraffin therapy,kinesiotherapy,etc.and the phantom limb pain and depression before and after the treatment were assessed by using visual analogue scale(VAS) and self rating depression scale(SDS). RESULTS:The intensity of pain was significantly decreased in the patients after treatment(P< 0.01,t=39.08).There was a significant decrease in the SDS scores in the patients after treatment,as compared with those before treatment(P< 0.01,t=15.55). CONCLUSION:It is practical and effective to treat the phantom limb pain after amputation with complex treatment, and its functional mechanism is initially discussed.

关 键 词：截肢 幻肢痛 综合疗法 康复治疗 抑郁 阿米替林 卡马西平 

分 类 号：R687.5[医药卫生—骨科学] R493[医药卫生—外科学]