Search

芬太尼透皮贴剂治疗晚期癌性疼痛的疗效观察

【摘要】　目的　观察芬太尼透皮贴剂治疗晚期癌性疼痛患者的疗效。　方法　2009年1月－2010年3月，对经病理学检查确诊为晚期恶性肿瘤的癌痛患者60例，使用芬太尼透皮贴剂进行止痛治疗。1周后观察患者疼痛缓解效果、KPS评分及芬太尼透皮贴剂不良反应。　结果　癌痛患者治疗前、后疼痛的缓解程度、KPS评分，差异有统计学意义（Plt;0.05），其药物不良反应发生率为36.67%，未见严重不良反应。　结论　芬太尼透皮贴剂止痛效果好，可帮助癌痛患者解除痛苦，改善生活质量。

Pain Care in Patients with Gynecologic Cancer:Report of 60 Cases

目的：探讨妇科癌症患者疼痛的护理措施。方法：60例妇科癌症患者随机分为常规护理、特殊护理，观察疼痛治疗效果。结果：特殊护理患者疼痛缓解明显。结论：护理干预能改善患者疼痛。

腹腔神经丛阻滞治疗癌性疼痛(附15例报告)

Research progress on the relationship between vitamin D and its receptor gene polymorphism and pain

Pain, as a complex physiological and pathological phenomenon, has always been a hot topic in medical research in terms of its mechanism of occurrence and influencing factors. Vitamin D, as a fat soluble vitamin, has been shown to be closely associated with pain in recent years, in addition to its classic role in regulating calcium and phosphorus metabolism. The polymorphism of the vitamin D receptor (VDR) gene can lead to changes in the structure and function of VDR, thereby affecting vitamin D levels. Meanwhile, VDR gene polymorphism can indirectly or directly participate in the occurrence and development of pain. This article aims to review the research on the relationship between vitamin D and its receptor gene polymorphism and pain, and provide reference for potential therapeutic targets and personalized intervention strategies for pain.

TREATMENT OF LUMBAR STENOSIS AND ROOT PAIN RESULTING FROM SIMPLE HYPERTROPHY OF LUMBAR LIGAMENTUM FLAVUM

OBJECTIVE: To provide a better treatment method of lumbar stenosis and root pain resulting from simple hypertrophy of ligamentum flavum. METHODS: By studying the records of 143 lumbar pain cases, we found 5 cases caused by simple hypertrophy of ligamentum flavum. All the patients were old man with a long progressed history. There was little difference of clinical features between the disc herniation and hypertrophy of ligamentum flavum. All cases accepted resection of ligamentum flavum. RESULTS: All the symptoms were relieved postoperatively. The patients could walk. CONCLUSION: The degeneration of lumbar ligamentum flavum can cause lumbar stenosis and root pain. Resection of ligamentum flavum can relieve the symptom.

Prevalence and risk factors of chronic pain after cesarean section: a systematic review

ObjectiveTo systematically review the prevalence and risk factors of the chronic post-cesarean section pain (CPCSP). MethodsPubMed, EMbase, The Cochrane Library, CINAHL, PsycInfo, CBM, WanFang Data, VIP, and CNKI databases were electronically searched to collect studies on the prevalence and risk factors of CPCSP from inception to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 15.1 software. ResultsA total of 43 studies involving 12 435 participants were included. The results of meta-analysis showed that the prevalence of CPCSP for 2 to 5 months, 6 to 11 months, and at least 12 months were 19% (95%CI 15% to 23%), 13% (95%CI 9% to 17%), and 8% (95%CI 6% to 10%), respectively. The risk factors included preoperative pain present elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety, postpartum depression, etc. ConclusionsThe current evidence shows that the overall prevalence of CPCSP is high. Preoperative pain presents elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety and postpartum depression may increase the risk of CPCSP.

慢性阻塞性肺疾病急性加重引起患者疼痛的病因初步探讨

目的初步探讨慢性阻塞性肺疾病（简称慢阻肺）急性加重引起患者不同部位疼痛发生的病因。方法回顾性分析自 2017 年 6 月至 2019 年 3 月入住徐州医科大学第二附属医院呼吸内科因慢阻肺急性加重引发不同部位疼痛的 50 例患者的临床资料。入选患者均依据病情需要给予化痰、抗感染、解痉止喘、吸氧改善通气等综合治疗。评估时间点为入院初治疗前、治疗后第 3 天、治疗后 1 周；评估方法采用简式麦吉尔疼痛问卷（SF-MPQ）量表对各时间点患者疼痛情况进行评分。同时评估各时间点患者血细胞分析、降钙素原、超敏 C 反应蛋白、血气分析；酶联免疫吸附试验法测定各时间点患者血清 5-羟色胺及缓激肽水平。结果与治疗前比较，经治疗后第 3 天、治疗后 1 周后，患者 SF-MPQ 疼痛量表评分值明显降低，血清 5-羟色胺及缓激肽水平降低（均 P<0.05）。患者 SF-MPQ 疼痛量表评分与血细胞分析中白细胞计数、超敏 C 反应蛋白、降钙素原、动脉血二氧化碳分压、血清 5-羟色胺及缓激肽水平呈正相关（均 P<0.05），与动脉血氧分压呈负相关（P<0.05）。结论慢阻肺急性加重引起的疼痛症状可能与全身炎症反应、低氧血症及体内二氧化碳潴留致高碳酸血症有一定关系。

Subxiphoid video-assisted thoracoscopic thymectomy versus traditional video-assisted thoracic surgery thymectomy for myasthenia gravis: A case control study

Objective To investigate the clinical outcomes of subxiphoid video-assisted thoracoscopic thymectomy for myasthenia gravis. Methods The clinical data of the 85 patients undergoing video-assisted thoracoscopic thymectomy for myasthenia gravis in Department of Cardiothoracic Surgery, Huashan Hospital affiliated to Fudan University between January 2014 and July 2016 were studied. Subxiphoid approach video-assisted thoracoscopic thymectomy (SXVT) and through traditional unilateral approach video-assisted thymectomy (TVAT) were compared. The clinical outcomes of SXVT and TVAT were compared. Results There was no surgical death and no statistical difference between the two groups in drainage time, postoperative volume of drainage, postoperative hospital stay and bleeding volume during operation (P>0.05). However, the acute chest pain after surgery, as well as the postoperative chest pain, and operative time were less in the the SXVT group than that in the TVAT group (P<0.05). Conclusion SXVT for myasthenia gravis is safe and executable. It can alleviate intercostal neuralgia and abnormal chest wall feeling. And it should be considered in the treatment of myasthenia gravis.

复方利多卡因乳膏减轻血透内瘘穿刺疼痛效果的观察

【摘要】目的观察复方利多卡因乳膏在减轻血液透析内瘘血管穿刺疼痛中的效果。方法将52例首次使用内瘘穿刺的血透患者,随机分为对照组和复方利多卡因乳膏组。对照组以常规方法进行穿刺;复方利多卡因乳膏组在穿刺前以穿刺点为中心涂擦复方利多卡因乳膏,60 min后进行穿刺。结果复方利多卡因乳膏组内瘘穿刺疼痛程度与对照组比较,差异有统计学意义(Plt;005)。结论复方利多卡因乳膏涂擦可减轻内瘘穿刺时的疼痛。

Efficacy of zoledronic acid on postoperative osteoporosis vertebral fracture patients undergoing percutaneous vertebroplasty or percutaneous kyphoplasty: a meta-analysis

ObjectiveTo systematically review the efficacy of zoledronic acid (ZOL) on postoperative osteoporosis vertebral fracture (OVFs) of patients undergoing percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).MethodsWe searched databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about ZOL on postoperative OVFs of patients undergoing PVP or PKP from inception to June 30th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.3 software was used for meta-analysis.ResultsA total of 11 RCTs involving 950 cases of OVFs were included. The results of meta-analysis showed that: the bone mineral densities of the ZOL group at 6 months (SMD=0.62, 95%CI 0.06 to 1.18, P=0.03) and 12 months (SMD=1.32, 95%CI 0.62 to 2.02, P=0.000 2) after the operation were higher than those of the control group. The re-fracture risk of the ZOL group was lower than that of the control group (RR=0.27, 95%CI 0.16 to 0.47, P<0.000 01). The visual analogue scales of the ZOL group were lower than those of the control group at 3 weeks (SMD=–1.03, 95%CI –1.42 to –0.63, P<0.000 01), 1 month (SMD=–1.57, 95%CI –2.30 to –0.83, P<0.000 01), 3 months (SMD=–1.53, 95%CI –2.20 to –0.86, P<0.000 01), 6 months (SMD=–2.59, 95%CI –3.42 to –1.76, P<0.000 01), and 12 months (SMD=–2.69, 95%CI –4.21 to –1.18, P=0.000 5) after the operation. In addition, Oswestry disability index (ODI) score of the ZOL group was better than that of the control group at 1 year after the operation (SMD=–1.61, 95% CI–2.42 to –0.81, P<0.000 1).ConclusionsThe current evidence shows that the usage of ZOL after PVP/PKP has better effects, it relieves the pain further, increases the quantity of bone significantly, ameliorates the BMD, reduces the incidence of re-fracture and improves the quality of life. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusion.