骨肉瘤截肢术后幻肢痛的临床观察

Clinical observation on phantom limb pain after the amputation of osteosarcoma

目的 探讨骨肉瘤截肢术后幻肢痛的发病率、疼痛特点及其治疗方法.方法 收集该科43例行骨肉瘤截肢术患者的临床资料,并对幻肢痛的发病率、疼痛特点及其治疗进行回顾性分析.结果 骨肉瘤截肢术后幻肢痛的发病率为93.02%.其疼痛类型主要为针刺痛（45.00%）、挤压痛（20.00%）、烧灼痛（25.00%）,疼痛多为发作性疼痛,阵发性加重.疼痛的强度多集中在NRS评分4～8分.予曲马多治疗后疼痛强度有下降,但差异无显著性意义（P＞0.05,t=1.941）;予曲马多＋卡马西平＋心里治疗后疼痛强度有显著性下降（P＜0.05,t=2.664）.结论 幻肢痛是骨肉瘤患者截肢术后的常见并发症,其治疗应以综合治疗为主.

[Objective] To investigate the disease incidence, feature of phantom limb pain（PLP） and the way of treatment for it after the amputation of osteosarcoma（OS）. [Methods] 43 patients with osteosarcoma underwent amputation; the disease incidence, feature of pain and the treatment for aU of these cases were analyzed retrespectivedly. [Results] The disease incidence of PLP was 93.02%. Needling, extrusion and cauterization were the main feature of pain. The strength of pain was main from 4 to 8 in the score of NRS. The intensity of pain was decreased after the treatment with Tramadol, but the difference was nonsignificance （P 〉0.05, t =1.941）. The intensity of pain was significantly decreased after the treatment with Tramadol Carbamazepine and psychotherapy （P 〈0.05, t =2.664）. [Conclusions] PLP was the common complication to the patient with osteosarcoma underwent amputation. The treatment of PIP should be thought by combined therapy.