疼痛的中枢机制.ppt

疼痛的中枢机制

疼痛DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

“Wemustalldie.ButthatIcansavehimfromdaysoftorture,thatiswhatIfeelismygreatandevernewprivilege.Painisamoreterriblelordofmankindthanevendeathitself.”-AlbertSchweitzerDepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

疼痛是与实际或潜在的组织损伤相关联的不愉快的感觉和情绪体验，或用这类组织损伤的词汇来描述的主诉症状； 无交流能力决不能否认一个个体正有着痛体验，需要适当缓解疼痛治疗的可能性； 疼痛既是一种生理感觉，又是对这感觉的一种情感反应。国际疼痛研究会（IASP）对疼痛的定义（2001):DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

疼痛的意义DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

n疼痛是一种警戒信号：表示机体已经发生组织损伤或预示即将遭受损伤，通过神经系统的调节，引起一系列防御反应，保护机体避免伤害。疼痛长期持续不止，便失去警戒意义，反而对机体构成难以忍受的精神折磨，严重影响学习、工作、饮食和睡眠，降低生活质量，产生一种不可忽视的经济和社会问题。DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

疼痛的产生DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

n由一定的刺激（伤害性刺激）作用于外周感受器（伤害性感受器），换能后转变成神经冲动（伤害性信息），循相应的感觉传入通路（伤害性传入通路）进人中枢神经系统，经脊髓、脑干、间脑中继后直到大脑边缘系统和大脑皮质，通过各级中枢整合后产生疼痛感觉和疼痛反应。DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.

Anesthesiology,

?游离的神经末梢?广泛分布于机体的皮肤、肌肉、关节和内脏等不同组织DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.伤害感受器

主要是Aδ和C纤维 沿背根进入脊髓背角 再将伤害信息传向脊髓以上的结构DepartmentofAnesthesiology,RuiJinHospital,ShanghaiSecondMedicalUniversity.传入伤害信息

DepartmentofAnesthesiology,RuiJinHospit