查看截肢者疼痛管理的来源

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您请求的操作仅限于组中的用户:==内生性疼痛==截肢后疼痛可孤立于残肢，也可表现为幻肢痛。对许多人来说，疼痛不仅仅是由手术创伤引起的，还包括一种被称为幻肢痛(PLP)的神经性表现。当截肢是由创伤事件造成的，例如在灾难环境中，同一肢体或身体其他部位的共存损伤可能会使截肢变得复杂。对于参与康复早期和急性后阶段的物理治疗师来说，挑战在于确定需要注意的伤害性和神经性原因，以便管理患者，从而使有效的康复发生。“截肢后疼痛”:截肢后伤口疼痛应与残肢和幻肢疼痛区分开来。截肢后，三者可能同时发生CM, Kooijmana Dijkstra PU, Geertzena JHB等。上肢截肢者的幻痛和幻感:一项流行病学研究。 # "残肢疼痛(RLP) ":患者经常能在截肢部位的邻近区域感到疼痛或感觉。这被称为残肢(RLP)或残肢痛。它常与PLP混淆，且其强度常与PLP呈正相关MacIver K, Lloyd DM, Kelly S等。 Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery. Brain 2008;131:2181–91..  #'''Phantom Limb Sensation''': This is a normal experience for the majority of amputees, but it is '''not''' a noxious sensation, which might be described by the patient as unpleasant. Often it can be described as a light tingling sensation, or in such cases re-assurance is the keyLe Feuvre P, Aldington D. Know Pain Know Gain: proposing a treatment approach for phantom limb pain. J R Army Med Corps 2014; 160(1):16-21 http://jramc.bmj.com/content/160/1/16.full.pdf+html. #'''[[Phantom limb pain|Phantom Limb Pain (PLP)]]''': Classified as neuropathic pain, whereas RLP and post-amputation pain are classified as nociceptive pain. PLP is often more intense in the distal portion of the phantom limb and can be exacerbated or elicited by physical factors (pressure on the residual limb, time of day, weather) and psychological factors, such as emotional stress. Commonly used descriptors include sharp, cramping, burning, electric, jumping, crushing and cramping. In addition to these 4 pain types that can be experienced following amputation, clinicans should also be aware of pain that may be caused by [[Pathology leading to amputation|co-existing pathology]]: #'''Vascular pain''' - such as exercise induced claudication or pain caused by vascular disease #'''Musculoskeletal pain''' - pain from other injuries suffered during a traumatic amputation, musculoskeletal pain caused by abnormal gait patterns, pain caused by normal ageing processes, or excessive wear and tear on the joints and soft tissue of the residual limb. #'''Neuromas''' - localized pain, sharp/shooting/paraesthesia reproduced by local palpation and Tinel's sign, relieved by LA injection. 

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