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ENGLISH ABSTRACT
脊髓电刺激术的研究现状及其在难治性疼痛中的临床应用
郑莹
黄腾
吕丹
郑伟
王准
贺永进
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1673-4378.2018.09.016
The application of spinal cord stimulation to treat refractory pain
Zheng Ying
Huang Teng
Lyu Dan
Zheng Wei
Wang Zhun
He Yongjin
Authors Info & Affiliations
Zheng Ying
Department of Pain Management, Tianjin First Center Hospital, Tianjin 300192, China
Huang Teng
Tianjin Institute of Industrial Biotechnology Chinese Academy of Sciences, Tianjin 300304, China
Lyu Dan
Department of Pain Management, Tianjin First Center Hospital, Tianjin 300192, China
Zheng Wei
Department of Pain Management, Tianjin First Center Hospital, Tianjin 300192, China
Wang Zhun
Department of Pain Management, Tianjin First Center Hospital, Tianjin 300192, China
He Yongjin
Department of Pain Management, Tianjin First Center Hospital, Tianjin 300192, China
·
DOI： 10.3760/cma.j.issn.1673-4378.2018.09.016
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摘要

背景难治性疼痛因对传统药物、物理等常规治疗手段不敏感而成为长期困扰患者的顽疾。目前脊髓电刺激（spinal cord stimulation, SCS）已经在临床上用于治疗难治性疼痛，其有效性及安全性均得到多方验证。

目的对SCS的研究现状进行综述，详细介绍SCS在难治性疼痛的临床应用，为难治性疼痛提供新的治疗策略。

内容介绍SCS的原理、手术方法及并发症，总结SCS在难治性疼痛的临床应用、SCS患者的选择与禁忌证。

趋向SCS用于治疗难治性疼痛是一种安全、有效的辅助疗法，它的临床效果肯定，应用广泛，今后需要进一步研究，使其更好地运用于临床。

难治性疼痛;脊髓电刺激疗法
ABSTRACT

BackgroundRefractory pain is a chronic disease that is not responsive to conventional medications and physical therapy. Spinal cord stimulation (SCS) has been recently employed to treat refractory pain, and its efficacy and safety have been verified.

ObjectiveThis article aims to review the clinical application of SCS in the treatment of refractory pain.

ContentThe electrode for SCS is inserted into epidural space to stimulate spinal dorsal fasciculus and sensory neurons. The overall effect of SCS is blocking pain signal transduction probably by enhancing the release of γ-aminobutyric acid, but inhibiting the release of glutamate in the spinal cord dorsal horn. Refractory pain has been reported in failed back surgery syndrome, complex regional pain syndromes, painful diabetic peripheral neuropathy, and postherpetic neuralgia. In 80% of patients with refractory pain, SCS shows therapeutic efficacy much better than conventional treatments, and improves sleeping, as well.

TrendSCS is a safe and effective method for the treatment of refractory pain.

Refractory pain;Spinal cord electrical stimulation
He Yongjin, Email: mocdef.qabq916312526
Copyright by Chinese Medical Association
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引用本文

郑莹,黄腾,吕丹,等. 脊髓电刺激术的研究现状及其在难治性疼痛中的临床应用[J]. 国际麻醉学与复苏杂志,2018,39(9)：888-891.

DOI:10.3760/cma.j.issn.1673-4378.2018.09.016

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难治性疼痛是指患者对常规的治疗手段缺乏疗效，并且即使口服和静脉注射大量阿片类药物也无法缓解的疼痛。目前它已成为一个广受关注的社会和医疗难题 [ 1 ]。1967年Shealy等 [ 2 ]将50 Hz的方波电流刺激猫的脊髓后索，疼痛刺激被抑制，这是人类首次发现脊髓电刺激（spinal cord stimulation, SCS）可以用于治疗难治性疼痛。此后SCS在20世纪70年代初就应用于临床，目前已有大量患者使用SCS进行疼痛治疗。临床研究表明SCS使患者疼痛缓解，而且SCS治疗不破坏神经结构，可根据病情变化调整治疗参数 [ 3 ]。目前SCS的有效性及安全性均得到验证 [ 4 ]，它具有较低的侵袭性且具有可逆性，并相对安全，而且几乎没有副作用，没有成瘾性，具有长效的治疗效果 [ 5 ]。本文将从SCS的研究现状和在难治性疼痛中的临床应用进行综述，希望能为临床工作提供参考。
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