四、电刺激镇痛的临床应用[10,11]<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> 电刺激镇痛主要用于顽固性慢性疼痛,包括腰背痛、四肢痛、头痛、偏头痛、灼性神经痛、幻肢痛、关节痛、肢体缺血性疾病、疱疹后神经痛、周围神经损伤、三叉神经痛、产痛、癌痛、血栓性脉管炎、脊髓损伤、反射性交感性营养不良、脑血管意外等。较少用于急性疼痛。也可用来治疗心绞痛以及改善外周血液循环、缓解术后痛、治疗神经原性膀胱、多发性硬化等 疼痛治疗的原则为采用简单又有效的治疗方法即所谓KISS(Keep it simple and sweet)原则。电刺激镇痛作为一种治疗疼痛的物理方法,具有明确的镇痛效应,几乎适用于各种类型的疼痛,具有安全、使用方便、副作用小等突出特点,临床应用价值很高,尤其是与其它镇痛药物和/或方法联合应用于多模式镇痛。但鉴于疼痛的病理生理机制复杂,病人的个体差异较大,以及不同频率的镇痛机制还存在许多疑问,电刺激镇痛还有待进一步深入研究。 参考文献 1. Sanderson JE, Ibrahim B, Waterhouse D, et al. Spinal electrical stimulation for intractable angina-Long-term clinical outcome and safety, Eur Heart J, 1994;15:810 -814. 2. Eliasson T, Jern S, Augustinsson LE, et al. Safety aspects of spinal cord stimulation in severe angina pectoris, Coron Artery Dis,1994;5:845-850. 3. Melzack R & Wall PD. Pain mechanisms: a new theory, Science, 1965;150:971-979. 4. Han JS, Qiang W. Mobilization of specific neuropeptides by peripheral stimulation of identified frequencies. News Physiol Sci 1992; 7: 176-180 5. Meyersn BA, Linderoth B. Mechanisms of spinal cord stimulation in neuropathic pain. Neurol Res. 2000 ;22(3):285-92. 6. Meglio M. Spinal cord stimulation in chronic pain management. Neurosurg Clin N Am. 2004 ;15(3):297-306. 7. Kumar K, Toth C, Nath RK. Spinal cord stimulation for chronic pain in peripheral neuropathy. Surg Neurol. 1996 ;46(4):363-9. 8. Alexander JR Macdonald, Tim W Coates.The Discovery of Transcutanous Spinal Electro-analgesia (TSE) and its Relief of Chronic Pain.Physiotherapy 1995;81:653-62. 9. A D Towell, D Williams, S G Boyd. High Frequency Non-Invasive Stimulation Over the Spine: Effects on Mood and Mechanical Pain Tolerance in Normal Subjects. Behavioral Neurology 1997;10:61-65 10.P. F. White Electroanalgesia: Does It Have a Place in the Routine Management of Acute and Chronic Pain Anesth. Analg., 2004; 98(5): 11971-11198. 11.Paul F. White, PhD, MD, FANZCA, Shitong Li, MD, and Jen W. Chiu, MB,et al. Electroanalgesia: Its Role in Acute and Chronic Pain Management. Anesth. Analg., 2001; 92(2): 505-13 |