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1.
Objectives: The present study analyzed the effect of therapy with therapeutic ultrasound on the sciatic nerve after compression injury, comparing two similar doses of SATA.

Methods: In total, 32 Wistar rats were used, divided into the following groups: CG — control; IG — compression injury of the sciatic nerve; IGCU — injury and continuous ultrasound; and IGPU — injury and 20% pulsed ultrasound. The treatment with ultrasound started on the 3rd postoperative day, with a frequency of 1 MHz, 0.4 W/cm² (SATA) for IGCU. IGPU received 2.0 W/cm2 (SATP), with 20% of the active cycle, for 3 minutes. The treatment was performed on a daily basis, totaling 15 days of therapy. Evaluations were performed for functional, histological, and morphometric forms.

Results: Both the Sciatic Functional Index and the withdrawal threshold and grip strength failed to show an advantage of using therapeutic ultrasound. For the morphometric evaluations of nerve fiber diameter and axons, myelin sheath thickness, and G quotient and nerve fiber estimates, IGPU values were estimated to be significantly lower. The morphological analysis revealed intense inflammatory response and neovascularization, as well as degeneration of axons and the myelin sheath, for the injury group and IGCU; however, IGPU showed greater tissue disorganization.

Conclusion: There were no significant differences, showing functional or nocicepitive recovery of the treated groups, including with characteristics pointing to the pulsed group with worse results.  相似文献

2.
目的:研究弧刃针刀治疗重症肩周炎所致神经痛的临床疗效,探讨弧刃针刀治疗重症肩周炎神经痛的优势。方法2011-07—2014-11纳入符合重症肩周炎诊断标准的患者73例,均采用弧刃针刀治疗,每周1次,3次为1个疗程。结果73例重症肩周炎患者,治愈69例,明显好转2例,好转1例,无效1例,有效率98.63%。结论弧刃针刀治疗重症肩周炎所致神经痛疗效确切,优势明显,值得临床推广。  相似文献
3.
4.
神经病理性疼痛是一种慢性、严重性、持续性疼痛,具有与伤害感受性疼痛不同的发病机制和治疗方案,早期明确诊断有助于及时有效地治疗神经病理性疼痛.目前,神经病理性疼痛的诊断主要依靠临床病史、神经系统检查和神经电生理学检查等,费时且效率低.近年来,用于筛查与评价神经病理性疼痛的量表被陆续开发并验证,成为神经病理性疼痛诊断与治疗和流行病学调查的重要工具,这些量表对神经病理性疼痛机制的研究亦具有重要意义.  相似文献
5.
痛性周围神经病以神经病理性疼痛为突出表现,可伴运动、感觉及自主神经功能异常,主要累及小纤维(Aδ和C纤维),根据病因可以分为遗传性和获得性.可为独立性疾病亦可为其他疾病表现的一部分,前者指特发性小纤维神经病.疼痛包括自发性和诱发性疼痛,表现为长度依赖性,呈现“手套-袜套”样分布.痛性周围神经病的主要辅助检查包括定量感觉检测、表皮内神经纤维密度、皮肤交感反应等.治疗原发病和控制疼痛是主要治疗手段,常用药物包括卡马西平、普瑞巴林、阿米替林等.  相似文献
6.
目的 系统评价加巴喷丁治疗带状疱疹后遗神经痛的疗效和安全性.方法 计算机检索美国国立医学图书馆(PubMed)、英国Cochrane图书馆随机对照临床试验资料库、荷兰医学文摘(EMBASE),以及中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、中国知识基础设施工程(CNKI)和万方数据库,并手工检索相关杂志,由两位研究者独立进行质量评价及数据分析,RevMan 5.0统计软件对数据进行Meta分析.结果 根据Cochrane5.0.2版随机对照临床试验质量评价标准,共纳入5项随机对照临床试验计1225例带状疱疹后遗神经痛患者.结果显示,加巴喷丁组患者平均每日疼痛评分改变高于安慰剂组(SMD=-0.920,95%CI:-1.330~-0.520;P=0.000);简易McGill疼痛问卷平均视觉印象评分改变高于安慰剂组(SMD=-2.650,95%CI:-3.410 ~-1.890;p=0.000);平均每日睡眠干预评分改变高于安慰剂组(SMD=-2.480,95%CI:-3.750~-1.200;P=0.000).加巴喷丁组与安慰剂组失访率差异无统计学意义(P=0.240).治疗期间常见药物不良反应为头晕、嗜睡、水肿等.结论 现有临床证据表明,加巴喷丁治疗带状疱疹后遗神经痛疗效显著,治疗保留率高;但应注意其所引起的头晕、嗜睡、水肿等药物不良反应.  相似文献
7.
目的探讨经颞入路手术后慢性疼痛与术后48 h内急性疼痛之间的相关关系。方法选择176例经颞入路手术患者,术后分别接受吗啡(30 mg)、曲马多(1000 mg)和吗啡(20 mg)+氟比洛芬酯(200 mg)自控镇痛治疗,采用视觉模拟评分(VAS)评价术后4、16、24和48 h静息和运动状态下疼痛程度,术后3个月时进行简易McGill疼痛问卷(SF.MPQ)调查,比较急慢性疼痛发生特点、分析二者之间相关关系,以及3种镇痛药物之镇痛效果。结果对可能影响术后疼痛程度的观察指标比较,其差异无统计学意义(P>0.05)。术后48 h内,各组患者不同观察时间点VAS评分随时间的延长有所改善,曲马多组(2.91±1.64)患者分别高于吗啡组(2.19±1.68)和氟比洛芬酯组(1.71±1.17,P<0.05);但各组慢性疼痛发生率和严重程度差异无统计学意义(P>0.05),慢性疼痛总发生率约为71.02%(125/176)、中至重度疼痛15.91%(28/176)。慢性疼痛与术后急性疼痛(48 h内)严重程度呈正相关(静息状态:rs=0.171,P=0.012;运动状态:rs=0.190,P=0.006);慢性疼痛SF.MPQⅡ评分>0与SF.MPQⅡ=0对应的急性疼痛VAS评分差异有统计学意义(P<0.05)。结论经颞入路手术后慢性疼痛与术后48 h内急性疼痛有关,术后早期有效控制急性疼痛可降低慢性疼痛之发生率。  相似文献
8.
目的观察体外发散式冲击波治疗带状疱疹后遗神经痛的临床疗效。方法采用MP100型体外冲击波治疗系统治疗26例带状疱疹后遗神经痛患者,采用视觉模拟评分(VAS)和神经病理性疼痛量表(NPS)评价治疗前、治疗第2次时、治疗第1和第2个疗程时的临床效果。结果 26例患者中2例因治疗不便、2例因疗效欠佳而改用其他方法,其余22例均完成冲击波治疗。第1疗程结束时,疼痛症状不同程度缓解,VAS和NPS评分分别由治疗前的(8.41±1.11)和(1.88±0.59)分降至(6.15±1.23)和(1.38±0.60)分,治疗前后差异具有统计学意义(均P=0.000);第2疗程结束时,疼痛症状显著缓解,VAS和NPS评分持续下降,分别为(3.57±1.30)和(1.04±0.31)分,差异亦有统计学意义(均P=0.000)。结论体外发散式冲击波治疗可显著改善带状疱疹后遗神经痛患者的疼痛症状,是一种带状疱疹后遗神经痛保守治疗的有效方法。  相似文献
9.

Background

Observational pain tools (OPTs) are widely recommended in health care policies, clinical guidelines, and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life.

Aim

To explore hospice, secondary, and primary care physicians' and nurses' use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs.

Methods

Twenty‐three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n = 5), hospitals (n = 6), hospices (n = 4), and nursing homes (n = 10). Semistructured, face‐to‐face interviews were conducted. Interviews were digitally recorded, transcribed verbatim, and thematic analysis applied to identify core themes.

Results

Three key themes emerged: (1) use of OPTs in this vulnerable patient population, (2) barriers to the use of OPTs and lack of perceived “added value”, and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one‐quarter of participants (n = 13) routinely used OPTs. Reasons for nonuse included perceived limitations of such tools, difficulties with their use and integration with existing practice, and lack of perceived added value. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties.

Conclusions

Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice, and policy.  相似文献
10.

Objective

A variety of algorithms is used for nociceptive flexion reflex threshold (NFRT) estimation, but their estimation accuracy is unknown. We developed a computer based simulation model of the NFRT to quantify and compare the accuracy of available estimation algorithms.

Methods

This simulation model is based on basic characteristics of the NFRT and specified by data collected from 60 healthy volunteers. We validated the model by comparing simulated data with data obtained independently in another volunteer population. The model was used to quantify the accuracy of previously published NFRT estimation algorithm for three NFRT variabilities representing sensory deprivation, distraction and general anaesthesia.

Results

The dynamic staircase algorithm obtained most accurate NFRT estimates during all NFRT variabilities. The number of stimuli applied can be chosen higher to increase estimate precision or lower to reduce measurement time.

Conclusions

Our simulation model is a valid tool to measure the accuracy of NFRT estimation algorithms. It can be applied to analyse and develop algorithms. The dynamic staircase algorithm shows the highest precision in NFRT estimation and is recommended for NFRT studies.

Significance

Using optimized NFRT estimation algorithms increases precision in clinical and experimental NFRT studies and might therefore reduce the measurement effort necessary.  相似文献
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