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Biology

示范皮肤触感在慢性盆腔疼痛协会

Published: June 23, 2009 doi: 10.3791/1232

Summary

一个床边试验示范

Abstract

盆腔疼痛是一种常见的的是痛经和子宫内​​膜异位症相关的条件。周期性疼痛的变化以及由此产生的疼痛的严重事件,在一些妇女成为连续的,这种状况被称为慢性盆腔疼痛。这种状态可以存在的,即使经过适当的药物或手术治疗已被提起。它可以与腹壁的肌肉和骨盆内的肌肉,导致严重的性交疼痛和压痛。其他症状的肠易激和间质性膀胱炎是常见的。这个国家的发展的一个共同的标志是出现所谓的viscero体反射出现的皮肤触感。提出一个简单的床边测试皮肤触感存在,不需要过多的时间或特殊设备。这个测试的基础上与胆功能和内脏躯体反射(1 2)在感觉变化相关的前期工作。

测试题目后解释如何将执行测试的权限进行触感,是指在其中的刺激,通常不会痛苦是痛苦的主题解释的条件。在这种情况下,用棉签轻碰就不会痛苦。测试阳性,但女人突然疼痛或突然急剧指出。这种感觉的模式通常是在一个骨盆神经支配的皮节的离散模式。

基本病理是现在被解释为神经可塑性的证据一个后果严重和重复疼痛与脊髓背角的功能变化,内脏组织和由此产生的躯体症状(3)的功能改变的结果。

确认条件的重要性在于在提高认识,这一过程可能会出现与初始条件或已处理后,不约而同。它还允许医师评估的情况,从这个角度,疼痛的另类解释,可能是目前可能并不需要额外的手术。

Protocol

简介

在大多数情况下,皮肤触感领域将确定在腹部及会阴部,支配盆腔内结构的皮节- T11 - L1和S3,4,5分别。长期触感,是指一个痛苦的感觉刺激,通常不会痛苦的后果,在这种情况下,一个棉签文化的坚持。

1。腹部

  1. 进行测试的解释和权限进行。
  2. 女子公开腹部从肋骨到耻骨地区。
  3. 显示一个棉签文化坚持的女人和对她的手刷演示如何会觉得轻的压力。
  4. 女人是问,要注意一点,涂在皮肤上的光压变得棉签文化坚持夏普制定下腹壁。
  5. 棉签文化坚持,再轻轻放下的腹部和女人将注意在感觉没有改变的存在或会注意到在轰动的突发性和离散清晰度。重复这个过程直到整个区域的皮肤触感已经确定。这突如其来的尖锐感的存在是一个积极的测试定义。
  6. 在某些情况下的区域大,但在其他国家,他们将小。他们可以是单方面的,但通常会是双边的。

2。会阴

  1. 进行测试的解释和权限进行。
  2. 该女子暴露会阴部截石位。
  3. 显示一个棉签文化坚持的女人和对她的手刷演示如何会觉得轻的压力。
  4. 女人是问,要注意一点,涂在皮肤上的光压变得清晰棉签文化坚持整个会阴绘制。
  5. 文化棉签棒的方向,然后得出的臀部水平从臀部侧面向着肛门跨越的S3皮节。对侧重复这个过程。此外,棉签可以从阴唇地区直接后的方向,避免阴道区域。测试阳性被定义为存在一个急剧的感觉。
  6. 在会阴部,面积通常描述的S#皮节时积极。积极的结果可以看出单方面很好,但不太常用。

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Discussion

皮肤触感的存在表明该女子已在过去的神经病发生变化的程度剧烈的疼痛。虽然问题可能是由痛经或子宫内膜异位症的起源,一个新的条件已经出现 - 慢性盆腔疼痛。原来的状态可能会主动或静态的。认识到这一新的发展是很重要的耐心教育和康复护理启动进程。承认这个国家的发展,还可以允许临床医生探讨其他方案,并避免潜在的不必要的手术 - 特别是如果原来的状态已处理。

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References

  1. Giamberardino, M. A., Affaitati, G., Lerza, R., Lapenna, D., Costantini, R., Vecchiet, L. Relationship between pain symptoms and referred sensory and trophic changes in patients with gallbladder pathology. Pain. 114 (1-2), 239-249 (2005).
  2. Giamberardino, M. A. Women and visceral pain: are the reproductive organs the main protagonists? Mini-review at the occasion of the "European Week Against Pain in Women 2007. Eur J Pain. 12 (3), 257-260 (2008).
  3. Baranauskas, G., Nistri, A. Sensitization of pain pathways in the spinal cord: cellular mechanisms. Prog Neurobiol. 54 (3), 349-365 (1998).

Tags

医药,发行28,慢性盆腔疼痛,皮肤触感,触发点,痛经,子宫内膜异位症,性交痛
示范<em>皮肤触感</em>在慢性盆腔疼痛协会
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Jarrell, J. Demonstration ofMore

Jarrell, J. Demonstration of Cutaneous Allodynia in Association with Chronic Pelvic Pain. J. Vis. Exp. (28), e1232, doi:10.3791/1232 (2009).

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