臨床に役立つ神経障害性痛の理解

出版社： 文光堂
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発行日： 2015-05-25
分野： 臨床医学：外科  >  麻酔科学/ペイン
ISBN： 9784830628405
電子書籍版： 2015-05-25 （第1版第2刷）
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長年にわたり注目されてきた神経障害性痛について，その機序に関する末梢から中枢までのサイエンスを整理しつつ，周辺疾患も含めて疫学，病態，治療法を詳細に解説．

目次

  • 臨床に役立つ神経障害性痛の理解

    ―目次―

    総説
    　神経障害性痛の疫学
    解説
    ?．神経障害性痛の発生機序
    　1 末梢性の機序
    　2 脊髄の機序
    　3 脳の機序
    　　L 動物実験から見た痛みと情動
    　　L グリアと神経障害性痛
    　　L Lysophosphatidic acid（LPA）と神経障害性痛
    　　L PACAPと神経障害性痛
    II．診断・検査法
    　1 問診，理学的検査と知覚異常
    　2 画像検査：病態把握のための検査
    　　1）脳機能検査
    　　2）脊髄MRI検査
    　3 質問票：痛みの性状，神経障害性疼痛
    　4 質問票：不安，抑うつ，破局化，ADL，生活の質
    　5 電気生理検査
    III．治療総論
    　1 薬物療法
    　　L TRPV1拮抗薬
    　　L Ｎタイプカルシウムチャネル遮断薬
    　　L サブタイプ選択的ナトリウムチャネル阻害薬
    　　L NMDA拮抗薬
    　2 理学療法
    　3 神経ブロック
    　4 脊髄刺激
    IV．疾患各論
    　1 脊椎脊髄疾患
    　　1）頚髄症
    　　L 頚部疾患のインターベンショナル治療
    　　2）腰椎椎間板ヘルニア
    　　L 腰椎椎間板ヘルニアに対するインターベンション治療
    　　3）腰部脊柱管狭窄症
    　　L 脊柱管狭窄症に対するインターベンション治療
    　　4）腰椎手術後痛
    　　L FBSSに対するアプローチ法
    　2 帯状疱疹関連痛
    　　L 帯状疱疹痛に対する神経ブロックの有効な活用法
    　　L 帯状疱疹の痒み
    　3 糖尿病性ニューロパチー
    　4 複合性局所疼痛症候群
    　　L 骨折，捻挫後CRPS病態と予後，治療法
    　　L コンパートメント症候群の病態と予後，治療法
    　　L 血管穿刺後の遷延痛・CRPS病態と予後，治療法
    　　L CRPS発症早期/慢性期の理学療法
    　5 術後痛
    　　1）開胸術後痛
    　　2）鼡径ヘルニア術後痛
    　　3）乳房手術後痛
    　6 三叉神経痛
    　　L 三叉神経痛の外科的治療法：適応となる病態
    　7 舌咽神経痛
    　8 脊髄損傷
    　9 幻肢痛
    　10 腕神経叢引き抜き損傷
    　　L 腕神経叢引き抜き損傷の脳神経外科治療：適応と有効性
    　11 胸郭出口症候群
    　　L 胸郭出口症候群患者の麻酔科的治療
    　　L 胸郭出口症候群の多様性
    　12 肘部管症候群
    　13 前骨間神経麻痺/後骨間神経麻痺
    　14 手根管症候群
    　15 梨状筋症候群
    　16 脳梗塞・出血後疼痛
    　17 パーキンソン病と慢性痛
    　18 多発性硬化症
    　19 慢性炎症性脱髄性多発根ニューロパチー
    　20 化学療法に伴う痛み・しびれ（CIPN）の評価と治療
    　21 線維筋痛症
    　22 HIV関連神経疼痛
    　23 アミロイドーシス

    Q & A
    　不動化により生じる弊害は？−基礎的見地から−
    　CRPSに対して交感神経ブロックは有効か？
    　CRPSに対する交代浴は有効か？
    　乳房手術後の諸症状に対してSGBは有効か？
    　鏡療法の適応と治療効果は？
    　パーキンソン病に対する脳深部刺激療法のタイミングは？
    　神経障害性痛の発生と症状に遺伝子多型は関与するか？
    　FBSSの中で腰椎再手術が適応となる病態とは？
    　生体内再生治療（in-situ tissue engineering）の
    　　適応性と有効性は？
    　痛みの難治化には，後生的遺伝子修飾（エピジェネティクス）が
    　　関与するのか？
    　難治化への分岐点とは？

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総説

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Q & A

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