乳腺切除术后疼痛的介入治疗选择。
Interventional Treatment Options for Post-mastectomy Pain.
发表日期:2023 Aug 30
作者:
Aarthi Murugappan, Ashish Khanna
来源:
PHYSICAL THERAPY & REHABILITATION JOURNAL
摘要:
目前,乳腺癌是全球最常见的癌症,有效的一线治疗选择存在显著缺口。除了癌症诊断外,乳腺癌患者在治疗后还面临额外的疼痛和发病率。辐射纤维化、肌肉痉挛、肌肉疼痛、神经病变和肩膀功能受限是乳腺癌治疗和乳房重建的潜在副作用。乳腺癌切除术后疼痛综合征影响了25-60%的人。当前的综述旨在阐述干预性疼痛管理选择,以补充保守措施(物理治疗、药物治疗、局部膏剂)来帮助这些患者。现有许多新的干预程序可用于治疗乳腺手术后胸壁疼痛、神经痛和痉挛。当前最常见的干预程序包括肉毒毒素注射、斜方肌前平面块、肋间肩臂神经块、胸椎旁神经块、胸大肌神经块和脊椎起伏神经块。结合其中一种干预程序,同时进行物理治疗和药物干预,有助于管理每年被诊断和治疗的数百万乳腺癌患者的乳房切除术后疼痛综合征。© 2023. 作者,由 Springer Science+Business Media, LLC 授权独有许可,属于 Springer Nature 部分。
Breast cancer is currently the most prevalent cancer diagnosed globally, and there is a significant gap in the availability of effective first-line treatment options. In addition to a cancer diagnosis, breast cancer patients face additional pain and morbidity after treatment. Radiation fibrosis, muscle spasms, muscle pain, neuropathy, and limited shoulder function are all potential side effects of breast cancer treatment and breast reconstruction. Post-mastectomy pain syndrome affects 25-60% of people after breast surgery. The current review moves forward to explain interventional pain management options that can be used to supplement conservative measures (physical therapy, medication, topical ointments) to help these patients.There are many new interventional procedures to treat chest wall pain, neuropathic pain, and spasticity after breast surgery. Currently, the most commonly performed procedures are botulinum toxin injections, serratus anterior plane blocks, intercostobrachial nerve blocks, thoracic paravertebral nerve blocks, pectoralis nerve blocks, and erector spinae nerve blocks. Utilizing one of these interventional procedures, along with physical therapy and pharmacologic interventions, can help manage post-mastectomy pain syndrome in the millions of breast cancer patients diagnosed and treated every year.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.