The neural electricity stimulates the skill to treat chronic pain

The neural electricity stimulates the skill to treat chronic pain
The neural electricity stimulates the skill to treat chronic pain
Shanghai Communications University subsidiary the intersection of Rui Jin and the intersection of hospital and the intersection of function and chronic treatment of pain, friend of hall, Li, associate professor of treatment of department of neurosurgery, need pain department, multi-disciplinary participation such as department of nerve internal medicine, department of neurosurgery, dept. of orthopedics, psychologist, physiotherapist. While treating chronic pain, should define the reason which cause pain, if tumour, tissue or organ dissect the structure to change (for instance the intervertebral disc is outstanding) Pain caused, should treat and have illness coming on originally and dissect the structure to change to neural oppression first, then is for the the treatment of pain symptom. To persons who guards failing to respond to any medical treatment or appearing side effect that can't be tolerated such as drug therapy, nerve blocking, physical treatment, psychotherapy, acupuncture and moxibustion,etc., can adopt the treatment of department of neurosurgery, mainly include the neural blood vessel reduces pressure the skill, nerve adjust and control skill and nerve and damage three kinds of methods of skill. Neural blood vessel reduce pressure the intersection of skill and choice of indication their and surgery operate form norm already. The nerve is for pain to conduct different positions in the way and damage the operation or radio frequency to damages the skill. It is nearly two new developing technology over the past thirty years and the nerve adjusts and controls the skill, including the neural electricity stimulates anodyne in skill and sheath to infuse the skill. Improvement and progress of the modern science and technology of mechanism's understanding with having illness coming on to pain, the neural electricity stimulates the skill to already replace most nerve and damage the skill, become first-selected treatment means of obstinate chronic pain in the world. The electricity of spinal stimulates and treats the peripheral nerve to damage the neural electricity to stimulate the skill to be to for conducting not carrying on the electricity amazingly with the neural position of pain, reduce the conducting and receiving of pain, thus relieve pain. Can be divided into sport cortex electricity stimulating, brain electricity stimulating, spinal electricity stimulating, perineural electricity stimulating and regional electricity of peripheral nerve of deep department to be amazing according to the amazing position. The electricity of spinal is stimulated (SCS) It is most extensive to employ in the amazing field of neural electricity, is used mainly for treating the chronic pain of two big classes: Pain that neuropathy reason pained and ischemic disease caused. Neuropathy reason pains to include: Offer as a gift some pain syndrome of neuralgia, complexity etc. after peripheral nerve damaging pain, waist dorsal operation syndrome, chronic herpes zoster; Ischemic disease includes: Getting obstinate angina pectoris, around the intersection of artery and ill, etc disease, Renaud of obstructing etc.. Neuralgia that peripheral neural damage causes is the important indication of SCS, the analgesic effect is most satisfied with, it is longest too to sustain curative effect. The pain can be caused spontaneously or stimulates, often continued and sent in wound, operation, nerve oppressing, inflammation and supersession disorder (multiple neuropathy changed) When. The result of study of the great sample reveals, so long as indication is apt, SCS can probably make the neuralgia patient's pain relieve more than 50%, 60%~70% patient can reduce other consumption to ease pain medicine obviously, make the life better quality and organism function. In U.S.A., pain (FBS) after the dorsal operation of waist It is another main indication of SCS, accounts for over half of all SCS operation quantity. A comprehensive investigation result reveals, SCS can make pain relieve more than 50% to treat FBS. But the curative effect difference that SCS treats FBS is greater. Because some patients are mixing pain, SCS composition to injury pain left over after the operation, the electricity stimulates the result to be non- good, need to combine morphine drug therapy. In Europe, SCS is used mainly for treating ischemic disease. Since initial stage of the seventies of last century, treated the research focal point that angina pectoris is SCS, there are much literature reports every year. The studying of respects such as therapeutic economic benefits and social benefit, impact on case fatality rate and function mechanism to SCS,etc. made the progress greatly since 1987, it can often be up to 90% that efficient, patient's chest aches and breaks out the number of times, pain intensity, intaking amount of the Nitroglycerin are obviously reduced, the intersection of sport and person who able to bear that sport test and the intersection of movement and the intersection of terminal and time increase, heart function raise, life quality is improved. The cortex electricity of sport stimulates and improves the movement function The cortex electricity of sport is stimulated (MCS) Apply to 1991, is directed primarily to centre and peripheral afferent nerve blocking pain, such as aching, phantom limb of deformed limb after centre aching and amputation that causes after cerebral hemorrhage or infarction aches, neuralgia after the nervi trigeminus is damaged. This kind of pain is very difficult to stimulate and improve through the peripheral electricity, the electricity of the cortex of sport can inhibit the cerebral cortex from being near the regional impression of pain to stimulate, as to the pain patient behind the apoplexy of brain, can also improve the movement function of pain limbs. As to the thing that the centre spreads into blocking pain, the cortex electricity of sport is stimulated and can be called the ultimate healing solution. The perineural electricity stimulates and treats pain of back The perineural electricity is stimulated (PNS) Regional pain of innervation, the intersection of pillow and old neuralgia, have clear the intersection of complexity and some the intersection of pain and syndrome,etc. of innervation around the some mainly. It is the technology not launched until the past 10 years that the regional electricity of peripheral nerve is stimulated, put the electrode into the cover in the pain position directly through puncturing technology, stimulate the nerve endings of the pain position to achieve the analgesic effect through the electricity, is similar to the traditional acupuncture and moxibustion electrotheraph. His technical operation relatively simple, in theory may apply to treating stubbornness pain that fail in the other all positions of body surface of whole body, but the most frequently used one is low-back pain. In a word, the department of neurosurgery of the chronic pain treats the key to success and lies in understanding of patient's pain property, therapeutic method and treats the suitable choice of time. Should choose the operation scheme according to the patient's experience of and the doctor. For having benign pain of obvious neural oppression, skill of reducing pressure of the first-selected neural blood vessel; Feel and pain in neuropathy reason storing the patient, first-selected nervous regulation skill treatment in; And the destructive treatment is suitable for life cycle neuropathy and rational pain of shorter cancer pain, the popping or bringing out composition exists, and the patient relying mainly on injuring pain. Should also fully consider the patient's life cycle, life quality and the pain relevant psychology, society and economic factor before treating, grasp various indication that treat of department of neurosurgery strictly.


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