慢性腹壁疼痛诊断和鉴别诊断

目的探讨慢性腹壁痛（CAWP）的诊断和鉴别诊断方法。方法对27例CAWP病人临床表现进行观察和分析，并总结CA—WP与腹腔脏器引起的腹痛区别。结果（1）慢性腹壁痛主要原因是神经源性疼痛（67％），由叻间神经前皮支卡压，带状疱疹后神经痛，糖尿病末梢神经炎、肿瘤转移等引起。（2）腹壁肌筋膜疼痛综合征是次要原因（26％）。（3）其他原因较少见（7％）。CAWP特点是：与姿势有关腹壁局部疼痛，Carnette、Hover、Tinel征阳性，局部痛点阻滞有效。结论CAWP的诊断和鉴别诊断主要根据病史、临床表现和影像学检查，要求门诊医生有较全面的医学知识。

The Diagnosis and Differential Diagnosis of Chronic Abdominal Wall Pain

Objective To study the clinical character , diagnosis and differential diagnosis procedures of chronic abdominal wall pain( CAWP ).Methods:Observe and analysize on 27 CAWP patients and tell its difference from the pain resulted from the abdominal internals. Results 1.The main reasons of CAWP is neurogenic( n=18,67% ) , such as the entrapment of intercoastal nerve , postherpetic pain , neuritis caused by diabetic, etal.2.Myofascial pain of abdominal wall is secondatory ( n=7, 26% ).3.the other reasons is rare ( n=2, 7% ).The characteristics of CAWP were local abdominal pain related to posture, positive Carnette,Hover, Tinel s signs, local pain point blocking is effective.Conclusion The diagnosis and differential diagnosis of CAWP depended mostly the health record, clinical expression and radiology. The doctors were required to have better medical knowledge.