一例难治性脊髓损伤痛患者的处理：病例报道及文献综述

慢性疼痛是脊髓损伤众多后遗症之一，它会妨碍患者的基本活动、功能恢复及生活质量。脊髓损伤患者的疼痛常常难以治疗。有限的治疗选择，包括药物治疗和非药物治疗使疼痛的治疗更加困难。我们用检索词“脊髓损伤”或“脊髓损伤和疼痛”或“僵直”或“肌僵直”从Medline数据库查阅1975～2005年的关于脊髓损伤后疼痛的相关文章。我们也手工查阅了国际疼痛研究协会最近出版的关于脊髓损伤痛的书籍以及综述，同时检出参考文献中的相关文章。文中我们报道了一例难治性脊髓损伤痛患者，该患者通过采用综合性治疗措施成功治愈。同时对治疗方式的循证医学证据也进行了回顾。

Chronic pain is one of the more disturbing sequelae of spinal cord injury, often interfering with the basic activities, effective rehabilitation, and quality of life of the patient. Pain in the cord-injured patient is often recalcitrant to treatment. This dilemma is amplified by the limited availability of effective pharmacological and nonpharmacological treatment options. We identified relevant articles regarding pain after spinal cord injury from the Medline database from 1975 to 2005 using the search terms ＂spinal cord injury＂ or ＂spinal cord injuries＂ and ＂pain＂ or ＂spasticity＂ or ＂muscle spasms.＂ We also searched by hand the review articles in a recently published book from the International Association for the Study of Pain Press on spinal cord injury pain, and identified relevant articles through reference lists. We present a patient with intractable spinal cord injury pain who was successfully treated with a pain management plan that addressed the various aspects of spinal cord injury pain. The evidence for treatment options is reviewed.