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BMJ Case Rep:闻所未闻!冬泳竟能止痛!

2018-03-22 Yui 转化医学网

BMJ杂志的病例专栏近日报道了一例病例,建议医生对于术后的严重持续性疼痛可以采用一个新的方案,用短暂急剧的冷水游泳来代替强效止痛药和物理疗法。

BMJ杂志的病例专栏近日报道了一例病例,建议医生对于术后的严重持续性疼痛可以采用一个新的方案,用短暂急剧的冷水游泳来代替强效止痛药和物理疗法。

该病例是一名有面部过度潮红的症状的28岁男性,医生对他采取了内窥镜胸交感神经切除术的治疗方案,该手术需要切除胸腔内的触发神经,手术本身是成功的,但是10周后,无论是采用强效止痛药还是分期的物理疗法都没有办法缓解患者术后发生严重的持续性疼痛。

该男子解释说,锻炼和运动只会加剧他的痛苦,没有办法帮助他康复。此外身体上的疼痛给他带来了极大的不适,并且破坏了他的生活质量。

术前该男子是一名铁人三项运动员,之前在湍急水流的开放水域游泳的经验让他觉得冷水中游泳会帮助他缓解灼烧般的术后疼痛。

于是这名男子回到了之前铁人三项比赛的地点,他说,这项比赛的唯一入口就是从岸边一块突出的岩石跳入水中,参赛者被强制游泳60秒才能返回岸上。

作者报道说该男子十分惊讶自己在水中完全感受不到痛苦,并且自此之后疼痛也没有复发过,他已经恢复了术前的生活质量,并且能够参加各项体育活动,不需要依赖止痛药的帮助。

这样的病例报告目前只有一个,而且注意作者强调的:“鉴于回顾性病例报告的本质,在没有更多证据的情况下我们并不清楚是否在冷水中游泳能够直接具体地与疼痛的减轻相关。”

但是鉴于冷水游泳和疼痛缓解的时间有明确的先后关系,并且除了单纯的运气之外并没有其他的解释,作者还是冒险将冷水的冲击与快速疼痛缓解联系起来。

他们承认尽管机制目前尚不清楚,但是依旧是有一些生物学解释的。

突然浸入冷水的冲击可能引发了一系列交感神经系统活动,人体对此的反应与意识状态的改变有关。这反过来可能会影响疼痛的接受进而及时缓解疼痛。

至于为什么该患者的疼痛在很长一段时间内完全消失,作者认为他之前活动减少使他的疼痛持续,然而浸入冷水后他的疼痛有暂时的缓解,恢复了自由活动,从而打破了之前的恶性循环。

作者继续指出,如果常规的治疗对神经痛的治疗没有效果,这样的神经痛与大脑结构改变和遗留心理问题有关会很难治疗。

作者写道:“我们需要进一步的前瞻性的研究来评估强制性冷水游泳疗法的潜力,以期将其发展成一种帮助术后恢复的潜在有效的自然干预措施。”

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    2018-06-03 charl1234567
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    2018-12-12 gaoxiaoe
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    2018-03-24 yaanren
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