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疼痛等級

世界衛生組織(WHO)將疼痛等級分為：

O 度： 不痛；

Ⅰ度(du)：輕度(du)痛(tong)，為間歇(xie)痛(tong)，可不用(yong)藥(yao)；

II度： 中度痛(tong)， 為持續痛(tong)，影(ying)響休息，需(xu)用止痛(tong)藥；

III度： 重度痛(tong)， 為持續痛(tong)，不(bu)用(yong)藥不(bu)能緩(huan)解(jie)疼痛(tong)；

Ⅳ度：嚴重(zhong)痛(tong)，為(wei)持(chi)續劇痛(tong)伴(ban)血(xue)壓(ya)、脈(mo)搏等變化。

數字分級法（NRS）

對患者疼痛(tong)程度進行評估，將(jiang)疼痛(tong)程度用0-10個數字依次(ci)表(biao)示(shi)(shi)，0表(biao)示(shi)(shi)無疼痛(tong)，10表(biao)示(shi)(shi)最劇烈的疼痛(tong)。

按照疼(teng)(teng)痛(tong)對應的數字將疼(teng)(teng)痛(tong)程度分為：輕度疼(teng)(teng)痛(tong)（1-3），中(zhong)度疼(teng)(teng)痛(tong)（4-6），重度疼(teng)(teng)痛(tong)（7-10）。

針(zhen)尖刺(ci)手背、用力鼓掌，約1~3級(ji)；

頭發(fa)被拉扯、錐子刺大腿，小(xiao)于等于4級；

刀切(qie)到(dao)手、軟組(zu)織(zhi)受(shou)傷、扭傷扭傷等，約4~7級；

生產時(shi)，前期持續性的疼痛，2~3級，宮縮(suo)最厲害(hai)時(shi)，達(da)到7~8級；

燒傷、嚴(yan)重的腰椎(zhui)間盤突(tu)出(chu)癥、重度血管性頭(tou)痛(tong)、偏(pian)頭(tou)痛(tong)，8~9級(ji)；

三叉神經痛、帶狀皰疹引(yin)發的(de)神經痛、晚期腫瘤壓(ya)迫神經引(yin)發的(de)癌性疼痛等，10級。

十大疼痛

三叉神經痛

“三(san)叉(cha)神經(jing)痛(tong)(tong)(tong)(tong)(tong)”(“三(san)叉(cha)神經(jing)痛(tong)(tong)(tong)(tong)(tong)”有時也被(bei)稱為“臉痛(tong)(tong)(tong)(tong)(tong)”，容易與牙(ya)痛(tong)(tong)(tong)(tong)(tong)混淆。是(shi)一(yi)種發(fa)(fa)生在面部三(san)叉(cha)神經(jing)分(fen)布區內反復發(fa)(fa)作(zuo)的(de)陣發(fa)(fa)性劇烈神經(jing)痛(tong)(tong)(tong)(tong)(tong))是(shi)醫學界公認(ren)的(de)神經(jing)系(xi)統(tong)中(zhong)最痛(tong)(tong)(tong)(tong)(tong)苦、最頑固(gu)、治療最困難的(de)一(yi)種疾病(bing)，被(bei)公認(ren)為“天(tian)(tian)下第(di)一(yi)痛(tong)(tong)(tong)(tong)(tong)”，有“不死的(de)癌癥”之稱。三(san)叉(cha)神經(jing)痛(tong)(tong)(tong)(tong)(tong)是(shi)中(zhong)樞系(xi)統(tong)的(de)常見病(bing)和多(duo)發(fa)(fa)病(bing)，普通人群發(fa)(fa)病(bing)率高達千分(fen)之二，40歲以后多(duo)發(fa)(fa)病(bing)，女性多(duo)于(yu)男性。約為3∶2。除其發(fa)(fa)作(zuo)時劇烈疼(teng)痛(tong)(tong)(tong)(tong)(tong)難以忍(ren)受外，跟其“一(yi)觸(chu)即發(fa)(fa)”的(de)癥狀(zhuang)特點(dian)有著很(hen)大關(guan)系(xi)，很(hen)多(duo)患者因其這個特性，終日戰戰兢兢，如履薄(bo)冰，生怕碰到“扳(ban)機點(dian)”而引發(fa)(fa)疼(teng)痛(tong)(tong)(tong)(tong)(tong)，由(you)此可見，三(san)叉(cha)神經(jing)痛(tong)(tong)(tong)(tong)(tong)不僅(jin)僅(jin)是(shi)從身體(ti)上(shang)更(geng)是(shi)從心理上(shang)摧殘著患者。而且生孩子并不是(shi)持(chi)續性的(de)疼(teng)痛(tong)(tong)(tong)(tong)(tong)，而三(san)叉(cha)神經(jing)痛(tong)(tong)(tong)(tong)(tong)由(you)于(yu)難治愈，有的(de)患者每(mei)天(tian)(tian)有一(yi)種生不如死的(de)感覺。

癌癥晚期

癌癥(zheng)到了(le)晚期都會(hui)出現(xian)(xian)(xian)疼痛(tong)(tong)(tong)的(de)(de)情況，疼痛(tong)(tong)(tong)絕不(bu)僅僅是“局部”的(de)(de)。癌癥(zheng)到了(le)晚期會(hui)出現(xian)(xian)(xian)擴散(san)轉移(yi)現(xian)(xian)(xian)象(xiang)，同時(shi)伴有多種的(de)(de)并發(fa)癥(zheng)的(de)(de)發(fa)生，可以(yi)說痛(tong)(tong)(tong)苦(ku)的(de)(de)程度要(yao)比發(fa)現(xian)(xian)(xian)病癥(zheng)時(shi)要(yao)痛(tong)(tong)(tong)好多倍(bei)，而且癌癥(zheng)本身(shen)給人們(men)帶來的(de)(de)精神痛(tong)(tong)(tong)苦(ku)就很(hen)高(gao)，如果是癌癥(zheng)晚期則要(yao)承受身(shen)體了(le)心靈上(shang)的(de)(de)兩重創(chuang)傷，最嚴重的(de)(de)狀況的(de)(de)時(shi)候全身(shen)都會(hui)出現(xian)(xian)(xian)食欲不(bu)振、惡病質(zhi)等狀況。

燒傷

燒傷(shang)(shang)是(shi)由熱力（熱液、蒸汽(qi)、高溫氣體、火焰、電(dian)弧、灼熱金屬等）作用于人體所引(yin)起(qi)的(de)組(zu)織損(sun)害，二(er)級(ji)(ji)燒傷(shang)(shang)沒有(you)三級(ji)(ji)燒傷(shang)(shang)嚴重，卻比他痛，因為三級(ji)(ji)燒傷(shang)(shang)已(yi)經連(lian)神經末(mo)梢一(yi)塊燒掉了(le)，反(fan)而不(bu)是(shi)最疼的(de)。二(er)級(ji)(ji)燒傷(shang)(shang)就慘(can)了(le)，表皮層(ceng)真(zhen)皮層(ceng)都(dou)燒了(le)，神經組(zu)織卻沒有(you)，所以整個漫長的(de)恢復期，火燒的(de)感覺(jue)一(yi)秒鐘都(dou)不(bu)會消停。

分娩

生(sheng)孩子(zi)(zi)的(de)(de)(de)時(shi)候肚(du)子(zi)(zi)是最疼(teng)(teng)的(de)(de)(de)，子(zi)(zi)宮(gong)一(yi)波(bo)又(you)一(yi)波(bo)的(de)(de)(de)收(shou)(shou)縮(suo)引起如同波(bo)浪般(ban)的(de)(de)(de)疼(teng)(teng)痛(tong)是最主(zhu)要的(de)(de)(de)原因，在分(fen)娩的(de)(de)(de)時(shi)候這種子(zi)(zi)宮(gong)收(shou)(shou)縮(suo)，使肌纖維劇(ju)(ju)烈收(shou)(shou)縮(suo)、拉伸(shen)、甚至肌纖維斷裂，整個(ge)(ge)過(guo)(guo)程中產生(sheng)大量的(de)(de)(de)激素以及(ji)其他可以產生(sheng)疼(teng)(teng)痛(tong)的(de)(de)(de)物質，接(jie)連不斷的(de)(de)(de)促(cu)進宮(gong)縮(suo)，從而引起劇(ju)(ju)烈疼(teng)(teng)痛(tong)，另外宮(gong)頸(jing)擴張、子(zi)(zi)宮(gong)收(shou)(shou)縮(suo)壓(ya)迫、牽拉周圍器(qi)官和(he)韌(ren)帶(dai)也會造(zao)成肚(du)子(zi)(zi)、恥骨聯(lian)合、后背的(de)(de)(de)疼(teng)(teng)痛(tong)，第二產程會陰、陰道過(guo)(guo)度(du)伸(shen)展和(he)壓(ya)迫也會造(zao)成疼(teng)(teng)痛(tong)。所以子(zi)(zi)宮(gong)收(shou)(shou)縮(suo)的(de)(de)(de)疼(teng)(teng)痛(tong)是一(yi)個(ge)(ge)混合性疼(teng)(teng)痛(tong)，它屬于內臟痛(tong)的(de)(de)(de)一(yi)種。

被子彈蟻螫傷

子彈(dan)蟻因(yin)為(wei)螫(shi)人時產生的(de)劇烈疼(teng)痛(tong)而得名。人在被(bei)子彈(dan)蟻叮咬之后，接下來的(de)12到24小時內都會體驗(yan)著毒(du)液所帶來的(de)持續疼(teng)痛(tong)。昆蟲學家賈(jia)斯汀(ting)·斯密特(te)博(bo)士對兇猛的(de)子彈(dan)蟻進行了(le)近距離(li)觀(guan)察(cha)，并將(jiang)其(qi)評為(wei)世界上螫(shi)人最疼(teng)的(de)昆蟲。他形容被(bei)子彈(dan)蟻螫(shi)到的(de)體驗(yan)是“純粹、強烈、無(wu)與倫比的(de)疼(teng)痛(tong)。就(jiu)像(xiang)走在燃燒的(de)木(mu)炭之上，同時膝蓋還釘(ding)著七(qi)八厘米長的(de)釘(ding)子”。

腰(yao)(yao)椎間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)癥(zheng)在人群中的(de)(de)(de)發(fa)病率約為(wei)2%，而 10%患(huan)者(zhe)(zhe)會(hui)出(chu)(chu)(chu)(chu)(chu)現(xian)超過(guo)3個月的(de)(de)(de)臨床癥(zheng)狀(zhuang)(zhuang)，腰(yao)(yao)間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)癥(zheng)由于(yu)(yu)腰(yao)(yao)部(bu)是(shi)人體活動的(de)(de)(de)樞紐，腰(yao)(yao)間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)癥(zheng)承受(shou)了(le)很(hen)大的(de)(de)(de)擠(ji)壓和扭(niu)轉應力，腰(yao)(yao)間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)癥(zheng)故腰(yao)(yao)部(bu)的(de)(de)(de)椎間(jian)盤(pan)最易(yi)發(fa)生變(bian)性破裂(lie)，腰(yao)(yao)間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)癥(zheng)在輕(qing)微的(de)(de)(de)腰(yao)(yao)扭(niu)傷或(huo)(huo)感受(shou)風寒濕外邪(xie)等外因的(de)(de)(de)作(zuo)用下(xia)，發(fa)生間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)，當(dang)腰(yao)(yao)椎間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)壓迫的(de)(de)(de)過(guo)于(yu)(yu)嚴(yan)(yan)重，對(dui)馬尾(wei)神經造成了(le)刺激，很(hen)多(duo)患(huan)者(zhe)(zhe)的(de)(de)(de)癥(zheng)狀(zhuang)(zhuang)就比較(jiao)嚴(yan)(yan)重了(le)，這樣的(de)(de)(de)患(huan)者(zhe)(zhe)會(hui)表現(xian)出(chu)(chu)(chu)(chu)(chu)明(ming)顯(xian)(xian)的(de)(de)(de)大小便失禁，會(hui)陰以及肛(gang)周(zhou)的(de)(de)(de)感覺出(chu)(chu)(chu)(chu)(chu)現(xian)麻(ma)木(mu)異常，有(you)的(de)(de)(de)患(huan)者(zhe)(zhe)甚至會(hui)出(chu)(chu)(chu)(chu)(chu)現(xian)雙(shuang)下(xia)肢的(de)(de)(de)不完全癱(tan)瘓(huan)，腰(yao)(yao)間(jian)盤(pan)突出(chu)(chu)(chu)(chu)(chu)的(de)(de)(de)癥(zheng)狀(zhuang)(zhuang)多(duo)種多(duo)樣，有(you)的(de)(de)(de)患(huan)者(zhe)(zhe)嚴(yan)(yan)重到(dao)甚至不能進行正常的(de)(de)(de)睡眠，平臥(wo)以后(hou)會(hui)出(chu)(chu)(chu)(chu)(chu)現(xian)明(ming)顯(xian)(xian)的(de)(de)(de)疼痛，然而有(you)的(de)(de)(de)患(huan)者(zhe)(zhe)是(shi)平臥(wo)以后(hou)癥(zheng)狀(zhuang)(zhuang)會(hui)明(ming)顯(xian)(xian)的(de)(de)(de)減(jian)輕(qing)甚至消失，只要站(zhan)立或(huo)(huo)者(zhe)(zhe)是(shi)坐位的(de)(de)(de)時(shi)候(hou)，就會(hui)出(chu)(chu)(chu)(chu)(chu)現(xian)明(ming)顯(xian)(xian)的(de)(de)(de)疼痛。

重度血管性頭痛

血(xue)管(guan)性(xing)頭(tou)(tou)(tou)(tou)痛(tong)(tong)發(fa)作(zuo)時常(chang)伴有(you)惡心、嘔(ou)吐、出汗、心悸、畏光等自主神經(jing)(jing)功能紊亂(luan)癥狀。頭(tou)(tou)(tou)(tou)痛(tong)(tong)多呈輕至中(zhong)度全頭(tou)(tou)(tou)(tou)痛(tong)(tong)、脹痛(tong)(tong)，也(ye)可表(biao)現(xian)為枕(zhen)部、額部、雙顳(nie)部疼痛(tong)(tong)，用(yong)腦、用(yong)力(li)、活(huo)動頭(tou)(tou)(tou)(tou)部及(ji)改變體(ti)位時頭(tou)(tou)(tou)(tou)痛(tong)(tong)加(jia)重，常(chang)伴有(you)類似神經(jing)(jing)衰(shuai)弱癥狀。也(ye)常(chang)發(fa)作(zuo)呈現(xian)明顯血(xue)管(guan)跳痛(tong)(tong)，惡心嘔(ou)吐，典型的患(huan)者發(fa)作(zuo)前有(you)視力(li)模糊，眼(yan)花(hua)表(biao)現(xian)。頭(tou)(tou)(tou)(tou)痛(tong)(tong)常(chang)發(fa)作(zuo)于睡(shui)眠障礙、情緒激動、過度疲勞、過量喝(he)酒等之(zhi)后，女(nv)性(xing)患(huan)者在經(jing)(jing)期前后頭(tou)(tou)(tou)(tou)痛(tong)(tong)加(jia)重。

急性闌尾炎

單純(chun)性(xing)闌(lan)(lan)尾炎(yan)常呈陣發(fa)性(xing)或持續性(xing)脹痛(tong)和鈍痛(tong)，是(shi)普外科(ke)常見病和多發(fa)病，主要的表(biao)現(xian)就是(shi)右(you)下腹部疼(teng)痛(tong)，如果將疼(teng)痛(tong)分(fen)為(wei)10個等級(ji)(ji)(ji)，急性(xing)闌(lan)(lan)尾炎(yan)疼(teng)痛(tong)從最初的單純(chun)性(xing)闌(lan)(lan)尾炎(yan)的疼(teng)痛(tong)能達到(dao)3級(ji)(ji)(ji)或者(zhe)4級(ji)(ji)(ji)，如果闌(lan)(lan)尾炎(yan)不能夠(gou)有效的控制或者(zhe)及時手術，甚至形成(cheng)了穿孔、化膿和形成(cheng)腹膜炎(yan)時急性(xing)闌(lan)(lan)尾炎(yan)的疼(teng)痛(tong)可能會迅(xun)速(su)升級(ji)(ji)(ji)，有的嚴重的會達到(dao)9級(ji)(ji)(ji)或者(zhe)10級(ji)(ji)(ji)左右(you)。

腎結石

腎結(jie)石(shi)是泌尿(niao)系統常見的疾病之一(yi)，而且容(rong)易復發(fa)(fa)，腎結(jie)石(shi)疼痛(tong)在醫學(xue)上被分為內(nei)臟(zang)疼痛(tong)，一(yi)般都是因為結(jie)石(shi)排泄過程中導致輸尿(niao)管痙(jing)攣，腎臟(zang)積水，疼痛(tong)呈陣發(fa)(fa)性(xing)絞痛(tong)，疼痛(tong)向下腹部膀胱(guang)區及后腰部放散，同(tong)時有(you)血(xue)尿(niao)，還伴(ban)有(you)惡(e)心(xin)嘔吐胃內(nei)容(rong)物。患者因疼痛(tong)輾轉反側，痛(tong)不欲生。

牙神經痛

牙(ya)(ya)(ya)髓炎俗稱牙(ya)(ya)(ya)神(shen)經痛(tong)，柔軟(ruan)的牙(ya)(ya)(ya)髓被(bei)堅硬(ying)的牙(ya)(ya)(ya)釉質和(he)牙(ya)(ya)(ya)本(ben)質包圍(wei)著，當炎癥發(fa)(fa)(fa)(fa)生(sheng)(sheng)(sheng)時(shi)(shi)牙(ya)(ya)(ya)髓腔內(nei)炎癥因子無(wu)處釋放，于是越來越擠，壓迫到了神(shen)經，便產(chan)生(sheng)(sheng)(sheng)了痛(tong)不欲生(sheng)(sheng)(sheng)的感(gan)覺(jue)。表現(xian)為劇(ju)烈(lie)(lie)的難以(yi)忍(ren)受(shou)的疼(teng)痛(tong),疼(teng)痛(tong)的性(xing)質有以(yi)下特點：自發(fa)(fa)(fa)(fa)性(xing)疼(teng)痛(tong)，陣(zhen)發(fa)(fa)(fa)(fa)性(xing)加(jia)劇(ju)，呈間(jian)(jian)(jian)(jian)歇性(xing)發(fa)(fa)(fa)(fa)作，在無(wu)外(wai)界任(ren)何刺激的情況下患牙(ya)(ya)(ya)發(fa)(fa)(fa)(fa)生(sheng)(sheng)(sheng)劇(ju)烈(lie)(lie)疼(teng)痛(tong)，早期(qi)疼(teng)痛(tong)發(fa)(fa)(fa)(fa)作時(shi)(shi)間(jian)(jian)(jian)(jian)短，緩解時(shi)(shi)間(jian)(jian)(jian)(jian)較(jiao)長，隨(sui)著病情發(fa)(fa)(fa)(fa)展晚(wan)期(qi)則疼(teng)痛(tong)發(fa)(fa)(fa)(fa)作時(shi)(shi)間(jian)(jian)(jian)(jian)長，緩解時(shi)(shi)間(jian)(jian)(jian)(jian)較(jiao)短,乃至最后無(wu)緩解期(qi)。