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带状疱疹及后遗神经痛.ppt

发布:2018-12-18约6.47千字共21页下载文档
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Treating herpes zoster and postherpetic neuralgia: An evidence-based approach University of Rochester School of Medicine and Dentistry, Rochester, NY Annie.Philip,MBBS ? 以证据为基础的方法治疗带状疱疹和带状疱疹后遗神经痛 罗切斯特大学医学院和牙科,罗切斯特,纽约 安妮·菲利普,医学学士 Postherpetic neuralgia (PHN) is a management challenge—because of its severity, long duration, and potential for debilitation, often in the highly vulnerable elderly population. 带状疱疹后遗神经痛(PHN)是一个治疗的挑战,因为其严重程度、持续时间长、和常常潜伏在免疫力低下的老年人口中。 And, as the most common complication of an acute episode of herpes zoster (shingles) in an immunocompetent person, PHN is likely no stranger to your practice. 而且,在具有免疫力的人中,作为急性带状疱疹(带状疱疹)最常见的并发症,在你的临床实践中疱疹后神经痛并不少见。 Herpes zoster is one of the most common neurological problems, with an incidence of up to 1 million new cases per year in the United States. Although the precise number for the prevalence of PHN in the United States is unknown, investigators estimate it at 500,000 to 1 million 带状疱疹是一种最常见的神经系统的疾病,在美国,其发病率高达每年100万新增病例。虽然疱疹后神经痛患病率的确切数目在美国是未知的,但调查人员估计在50万-100万。 Major risk?factors for development of PHN after an episode of herpes zoster include: ? older age ? greater acute pain during herpes zoster ? greater severity of rash ? 带状疱疹发生后,发展为带状疱疹后遗神经痛的主要危险因素包括: 年龄 带状疱疹期更严重的疼痛 更严重的皮疹 PHN is commonly defined as “dermatomal pain that persists 120 days or more after the onset of rash.”5 The pain of PHN has been characterized as a stimulus-dependent continuous burning, throbbing, or episodic sharp electric shock-like sensation6 and as a stimulus-dependent tactile allodynia (ie, pain after normally nonpainful stimulus) and hyperalgesia (exaggerated response to a painful stimulus). 带状疱疹后遗神经痛通常定义为:“皮区出现皮疹后疼痛持续120天或更久。带状疱疹后遗神经痛的特点是:连续的烧灼感、闪电痛、触摸痛(即是无痛刺激后的疼痛)和痛觉超敏(疼痛刺激的放大反应) In addition, some patients experience myofascial pain secondary to excessive muscle guarding. Chronic pruritus can be present. 此外,有些病人的经验肌筋膜疼痛继发过度肌肉防御,可以产生慢性瘙痒。 More than 90% of patients who have PHN have allodynia,7
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