手术后或创伤后慢性疼痛

定义

慢性术后或创伤后疼痛是指在外科手术或组织损伤（包括烧伤在内的任何创伤）后出现或加剧的疼痛，并在愈合过程后持续存在，即手术或组织创伤后至少3个月。疼痛局限于手术区域或损伤区域，投射到位于该区域的神经支配区域，或指向皮肤（手术/损伤深层躯体或内脏组织后）。需要排除其他引起疼痛的原因，包括感染、恶性肿瘤等，以及既往疼痛问题导致的持续疼痛。

Chronic postsurgical or post traumatic pain is pain developing or increasing in intensity after a surgical procedure or a tissue injury (involving any trauma including burns) and persisting beyond the healing process, i.e. at least 3 months after surgery or tissue trauma. The pain is either localized to the surgical field or area of injury, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). Other causes of pain including infection, malignancy etc. need to be excluded as well as pain continuing from a pre-existing pain problem.

Chronic postsurgical or post traumatic pain is pain developing or increasing in intensity after a surgical procedure or a tissue injury (involving any trauma including burns) and persisting beyond the healing process, i.e. at least 3 months after surgery or tissue trauma. The pain is either localized to the surgical field or area of injury, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). Other causes of pain including infection, malignancy etc. need to be excluded as well pain as continuing from a per-existing pain problem. Dependent on type of surgery, chronic postsurgical or posttraumatic pain often may be neuropathic pain. Even if neuropathic mechanisms are crucial, the type of pain should be diagnosed here. The postsurgical or posttraumatic aetiology of the pain should be highly probable; if it is vague, consider using codes in the section of chronic primary pain. The most frequent surgical procedures causing chronic postsurgical pain are breast surgery (including mastectomy with or without axillary node dissection, cosmetic surgery), herniotomy (open or laparoscopic surgery), thoracic surgery (including minimally invasive procedures like thoracoscopic surgery) and the amputation of a limb or other organ. Dependent on the type of surgery, chronic postsurgical pain often may be neuropathic pain; on average chronic postsurgical pain is in 30% of cases of neuropathic origin (range 6 to 54% and more). Chronic pain can also develop after trauma; the incidence is reported in the range of 46 to 85% after multitrauma. Typical examples include post traumatic osteoarthritis after joint injuries, chronic pain after acute back injury, whiplash injury and burns injury. Even if neuropathic mechanisms are crucial, this type of pain should be diagnosed here. Diagnostic Criteria: Conditions A to E are fulfilled: A. Chronic pain (persistent or recurrent for longer than 3 months) is present. B. The pain began or increased in intensity after surgery or a tissue trauma. C. The pain is in an area of preceding surgery or tissue trauma. D. The pain persisted for at least 3 months after the initiating event. E. The pain is not better accounted for by an infection, a malignancy, a pre-existing pain condition or any other alternative [No translation available]

跨章引用 同一概念在其他章节另有编码

• 复杂性区域性疼痛综合征MG30.04

子条目 共 4 条

• MG30.20创伤后慢性疼痛
• MG30.21手术后慢性疼痛
• MG30.2Y其他特指的手术后或创伤后慢性疼痛
• MG30.2Z未特指的手术后或创伤后慢性疼痛

编码备注 Coding note

疼痛很大的可能性应是手术后或创伤后导致的；若病因不明确，则考虑按慢性原发性疼痛编码。

The postsurgical or posttraumatic aetiology of the pain should be highly probable; if it is vague, consider using codes in the section of chronic primary pain.