ОСОБЛИВОСТІ БОЛЬОВОГО СИНДРОМУ У ХВОРИХ НА КРИЛОПІДНЕБІННИЙ ГАНГЛІОНІТ

І.А. Колісник, П. І. Ткаченко, Артур Іванович Панькевич, Андрій Михайлович Гоголь
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Abstract

Relevance of the research. The features of complex anatomical and functional organization of the maxillofacial area, peripheral nervous system, as well as autonomic structures determine a variety of pathogenetic mechanisms of prosopalgia, among which the lesions of the pterygopalatine node are the most common. Despite the presence of a significant variety of clinical manifestations of pterygopalatine ganglionitis, the prevalence and variety of autonomic manifestations in this disease, the main complaint of patients is pain, the characteristics of which are quite different. The aim of our research was to study the nature of pain in patients with pterygopalatine ganglionitis. Material and methods of research. We examined 105 patients with pterygopalatine ganglionitis aged from 30 to 74 years. Patients were examined for the nature of pain and its intensity, the predominant time of onset and duration of pain attacks, the place of primary localization of pain and the area of its spread. A visual analog scale (VAS) was used to assess pain intensity. Based on the intensity of pain and depending on the severity of the disease, all patients were divided into three groups: mild, moderate and severe pterygopalatine ganglionitis. With a mild severity of pterygopalatine ganglionitis, the intensity of pain attacks is 4-5 points, lasting up to 30 minutes and with a frequency of 1-3 times a day with localization within one or two anatomical areas. With moderate severity, the intensity of pain attacks is 5-7 points, lasting from 30 minutes to 1-2 hours and with a frequency of 4-5 times a day with the gradual spread of pain from one area to half of the face. The severe course is characterized by pain attacks of 8-10 points, lasting for 2 hours or more and with a frequency of attacks from 4 to 6-10 per day. In addition, the pain, occurring in one anatomical area, gradually spread to half of the face, radiating to neighboring areas. Thus, analyzing the features of the pain syndrome in patients with pterygopalatine ganglionitis, we can conclude: 1. The intensity of pain, which was determined by VAS, increases depending on the severity of ganglionitis and ranges from 4.3 points in mild to 8.75 in severe ganglionitis. 2. The duration and frequency of pain attacks increase from 30 minutes with a frequency of 1-3 seizures per day in patients with mild pterygopalatine ganglionitis, to 2 or more hours and 4-10 seizures per day in patients with severe ganglionitis. 3. The localization of pain attacks extends from one anatomical area in mild ganglionitis to half of the face with the possibility of irradiation of pain in severe ganglionitis. 4. These clinical symptoms should be used in determining the severity of pterygopalatine ganglionitis and the choice of treatment tactics in the future.
研究的相关性。颌面部、周围神经系统以及自主神经结构复杂的解剖和功能组织特点决定了面痛症的发病机制多种多样,其中翼状腭结病变最为常见。尽管翼腭神经节炎的临床表现多种多样,但该疾病的患病率和自主神经表现的多样性,患者的主要主诉是疼痛,其特征有很大的不同。我们研究的目的是研究翼状腭神经节炎患者疼痛的性质。研究材料和方法。我们检查了105例30至74岁的翼腭神经节炎患者。检查患者疼痛的性质及其强度,主要发病时间和疼痛发作的持续时间,疼痛的原发部位和扩散区域。采用视觉模拟量表(VAS)评估疼痛强度。根据疼痛的强度和疾病的严重程度,将所有患者分为轻度、中度和重度翼腭神经节炎三组。轻度翼状腭神经节炎,疼痛发作强度为4-5点,持续时间可达30分钟,频率为每天1-3次,定位于一至两个解剖区域。中度,疼痛发作强度为5-7点,持续时间为30分钟~ 1-2小时,频率为每天4-5次,疼痛从一侧逐渐扩散到半面。严重病程的特点是疼痛发作8-10分,持续2小时或更长时间,发作频率为每天4次至6-10次。此外,疼痛发生在一个解剖区域,逐渐扩散到半张脸,辐射到邻近区域。因此,分析翼腭神经节炎患者疼痛综合征的特点,我们可以得出以下结论:1。疼痛强度根据神经节炎的严重程度而增加,轻度为4.3分,重度为8.75分。2. 疼痛发作的持续时间和频率从轻度翼腭神经节炎患者每天30分钟,1-3次发作频率增加到严重神经节炎患者每天2小时或更长时间,4-10次发作。3.疼痛发作的定位从轻度神经节炎的一个解剖区域延伸到半脸,严重神经节炎的疼痛可能照射。4. 这些临床症状应用于确定翼腭神经节炎的严重程度和今后治疗策略的选择。
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