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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：輕(qing)度痛，為間(jian)歇(xie)痛，可不用藥；

II度： 中度痛， 為(wei)持(chi)續痛，影(ying)響休(xiu)息，需用止(zhi)痛藥；

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

Ⅳ度：嚴重痛，為持續劇痛伴血壓、脈搏等(deng)變化。

數字分級法（NRS）

對患(huan)者疼痛(tong)程度(du)進行評估，將疼痛(tong)程度(du)用0-10個數字依次表(biao)示(shi)，0表(biao)示(shi)無疼痛(tong)，10表(biao)示(shi)最劇烈的疼痛(tong)。

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

針尖刺手背、用力(li)鼓(gu)掌，約1~3級；

頭發被拉扯(che)、錐(zhui)子(zi)刺大(da)腿，小于等于4級；

刀(dao)切到手、軟組織受傷、扭(niu)傷扭(niu)傷等(deng)，約4~7級；

生產時，前期持續(xu)性(xing)的疼痛，2~3級(ji)，宮(gong)縮最厲(li)害時，達到(dao)7~8級(ji)；

燒(shao)傷、嚴重的腰(yao)椎間盤突(tu)出癥、重度血管性頭(tou)痛(tong)(tong)、偏頭(tou)痛(tong)(tong)，8~9級；

三(san)叉神經痛(tong)(tong)(tong)、帶狀(zhuang)皰(pao)疹引發(fa)的神經痛(tong)(tong)(tong)、晚(wan)期腫瘤壓迫神經引發(fa)的癌性(xing)疼(teng)痛(tong)(tong)(tong)等，10級。

十大疼痛

三叉神經痛

“三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong)”(“三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong)”有(you)(you)時也被稱為“臉痛(tong)(tong)(tong)(tong)(tong)(tong)”，容易與(yu)牙痛(tong)(tong)(tong)(tong)(tong)(tong)混淆。是(shi)(shi)一(yi)種發生(sheng)在面部三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)分布(bu)區(qu)內反復(fu)發作的(de)(de)(de)(de)(de)陣發性(xing)(xing)劇烈神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong))是(shi)(shi)醫學界公認(ren)的(de)(de)(de)(de)(de)神(shen)經(jing)(jing)(jing)系(xi)統(tong)中最(zui)痛(tong)(tong)(tong)(tong)(tong)(tong)苦(ku)、最(zui)頑固、治療最(zui)困難的(de)(de)(de)(de)(de)一(yi)種疾病(bing)(bing)(bing)，被公認(ren)為“天(tian)下第(di)一(yi)痛(tong)(tong)(tong)(tong)(tong)(tong)”，有(you)(you)“不死(si)的(de)(de)(de)(de)(de)癌癥(zheng)”之(zhi)(zhi)稱。三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong)是(shi)(shi)中樞(shu)系(xi)統(tong)的(de)(de)(de)(de)(de)常(chang)見病(bing)(bing)(bing)和多發病(bing)(bing)(bing)，普通人群發病(bing)(bing)(bing)率(lv)高達千分之(zhi)(zhi)二，40歲以后(hou)多發病(bing)(bing)(bing)，女(nv)性(xing)(xing)多于男(nan)性(xing)(xing)。約為3∶2。除(chu)其(qi)發作時劇烈疼(teng)痛(tong)(tong)(tong)(tong)(tong)(tong)難以忍受外(wai)，跟其(qi)“一(yi)觸即發”的(de)(de)(de)(de)(de)癥(zheng)狀特點(dian)有(you)(you)著很(hen)大關系(xi)，很(hen)多患(huan)者(zhe)因其(qi)這個特性(xing)(xing)，終日戰戰兢(jing)兢(jing)，如(ru)履薄(bo)冰，生(sheng)怕碰到(dao)“扳機點(dian)”而引發疼(teng)痛(tong)(tong)(tong)(tong)(tong)(tong)，由(you)此可見，三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong)不僅僅是(shi)(shi)從(cong)身體(ti)上更(geng)是(shi)(shi)從(cong)心(xin)理上摧殘著患(huan)者(zhe)。而且生(sheng)孩子(zi)并(bing)不是(shi)(shi)持續性(xing)(xing)的(de)(de)(de)(de)(de)疼(teng)痛(tong)(tong)(tong)(tong)(tong)(tong)，而三(san)(san)(san)叉(cha)(cha)神(shen)經(jing)(jing)(jing)痛(tong)(tong)(tong)(tong)(tong)(tong)由(you)于難治愈，有(you)(you)的(de)(de)(de)(de)(de)患(huan)者(zhe)每天(tian)有(you)(you)一(yi)種生(sheng)不如(ru)死(si)的(de)(de)(de)(de)(de)感覺。

癌癥晚期

癌(ai)癥(zheng)(zheng)到(dao)了(le)(le)晚期都會(hui)出(chu)現(xian)(xian)疼痛(tong)的(de)情(qing)況(kuang)(kuang)，疼痛(tong)絕(jue)不(bu)僅(jin)僅(jin)是“局部”的(de)。癌(ai)癥(zheng)(zheng)到(dao)了(le)(le)晚期會(hui)出(chu)現(xian)(xian)擴散轉移現(xian)(xian)象，同時(shi)(shi)伴(ban)有多種的(de)并發(fa)癥(zheng)(zheng)的(de)發(fa)生，可以說痛(tong)苦的(de)程度要比發(fa)現(xian)(xian)病癥(zheng)(zheng)時(shi)(shi)要痛(tong)好多倍(bei)，而且癌(ai)癥(zheng)(zheng)本身給人(ren)們帶來(lai)的(de)精神痛(tong)苦就很高，如果是癌(ai)癥(zheng)(zheng)晚期則(ze)要承受身體了(le)(le)心(xin)靈上(shang)的(de)兩重創傷，最嚴重的(de)狀況(kuang)(kuang)的(de)時(shi)(shi)候全身都會(hui)出(chu)現(xian)(xian)食欲不(bu)振(zhen)、惡病質等狀況(kuang)(kuang)。

燒傷

燒傷(shang)是(shi)由熱力（熱液、蒸汽、高溫氣體、火焰、電(dian)弧、灼熱金屬(shu)等）作用于(yu)人體所引(yin)起的組(zu)(zu)織損害(hai)，二級(ji)燒傷(shang)沒有三級(ji)燒傷(shang)嚴重，卻(que)比他痛，因為三級(ji)燒傷(shang)已經連神經末梢一塊燒掉了(le)，反而不是(shi)最疼的。二級(ji)燒傷(shang)就(jiu)慘了(le)，表皮層真皮層都(dou)燒了(le)，神經組(zu)(zu)織卻(que)沒有，所以整(zheng)個漫長的恢復期(qi)，火燒的感(gan)覺(jue)一秒鐘都(dou)不會消停。

分娩

生(sheng)孩子(zi)的(de)(de)(de)時候肚(du)子(zi)是(shi)最疼(teng)(teng)(teng)(teng)的(de)(de)(de)，子(zi)宮(gong)一(yi)(yi)波(bo)又(you)一(yi)(yi)波(bo)的(de)(de)(de)收(shou)縮(suo)(suo)(suo)引起(qi)如同(tong)波(bo)浪般的(de)(de)(de)疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)是(shi)最主要的(de)(de)(de)原因(yin)，在(zai)分娩的(de)(de)(de)時候這種子(zi)宮(gong)收(shou)縮(suo)(suo)(suo)，使肌纖(xian)維劇烈收(shou)縮(suo)(suo)(suo)、拉(la)伸、甚(shen)至(zhi)肌纖(xian)維斷(duan)裂，整個過(guo)程(cheng)中產(chan)(chan)生(sheng)大量(liang)的(de)(de)(de)激(ji)素以(yi)及(ji)其他可(ke)以(yi)產(chan)(chan)生(sheng)疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)的(de)(de)(de)物質，接(jie)連不斷(duan)的(de)(de)(de)促進宮(gong)縮(suo)(suo)(suo)，從(cong)而引起(qi)劇烈疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)，另外宮(gong)頸(jing)擴張、子(zi)宮(gong)收(shou)縮(suo)(suo)(suo)壓(ya)迫、牽拉(la)周圍器(qi)官和韌帶也(ye)會造成(cheng)肚(du)子(zi)、恥骨聯合、后背的(de)(de)(de)疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)，第二產(chan)(chan)程(cheng)會陰、陰道(dao)過(guo)度伸展和壓(ya)迫也(ye)會造成(cheng)疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)。所以(yi)子(zi)宮(gong)收(shou)縮(suo)(suo)(suo)的(de)(de)(de)疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)是(shi)一(yi)(yi)個混合性疼(teng)(teng)(teng)(teng)痛(tong)(tong)(tong)，它屬于內臟痛(tong)(tong)(tong)的(de)(de)(de)一(yi)(yi)種。

被子彈蟻螫傷

子(zi)彈蟻(yi)因(yin)為螫(shi)人時產生的(de)(de)(de)劇烈疼(teng)(teng)痛而得名。人在(zai)被(bei)(bei)子(zi)彈蟻(yi)叮咬之后，接(jie)下來的(de)(de)(de)12到24小時內都會體(ti)(ti)驗著(zhu)毒液所帶來的(de)(de)(de)持續疼(teng)(teng)痛。昆(kun)蟲學家賈斯(si)汀·斯(si)密特博士對兇猛的(de)(de)(de)子(zi)彈蟻(yi)進(jin)行了近距離(li)觀(guan)察，并(bing)將其(qi)評為世界上螫(shi)人最疼(teng)(teng)的(de)(de)(de)昆(kun)蟲。他(ta)形(xing)容被(bei)(bei)子(zi)彈蟻(yi)螫(shi)到的(de)(de)(de)體(ti)(ti)驗是“純粹、強烈、無與(yu)倫比的(de)(de)(de)疼(teng)(teng)痛。就像走在(zai)燃(ran)燒的(de)(de)(de)木炭(tan)之上，同時膝蓋還釘(ding)著(zhu)七八厘米長的(de)(de)(de)釘(ding)子(zi)”。

腰(yao)(yao)(yao)(yao)(yao)椎間(jian)(jian)盤(pan)(pan)(pan)突(tu)出癥(zheng)(zheng)(zheng)在(zai)人群中的(de)(de)(de)(de)發(fa)病率約為(wei)2%，而(er)(er) 10%患者(zhe)(zhe)會(hui)(hui)(hui)(hui)出現超過3個月的(de)(de)(de)(de)臨床癥(zheng)(zheng)(zheng)狀(zhuang)，腰(yao)(yao)(yao)(yao)(yao)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出癥(zheng)(zheng)(zheng)由于腰(yao)(yao)(yao)(yao)(yao)部是人體活(huo)動的(de)(de)(de)(de)樞紐，腰(yao)(yao)(yao)(yao)(yao)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出癥(zheng)(zheng)(zheng)承受(shou)了(le)很大(da)的(de)(de)(de)(de)擠壓(ya)和扭轉應力(li)，腰(yao)(yao)(yao)(yao)(yao)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出癥(zheng)(zheng)(zheng)故(gu)腰(yao)(yao)(yao)(yao)(yao)部的(de)(de)(de)(de)椎間(jian)(jian)盤(pan)(pan)(pan)最(zui)易發(fa)生(sheng)變性(xing)破裂，腰(yao)(yao)(yao)(yao)(yao)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出癥(zheng)(zheng)(zheng)在(zai)輕微的(de)(de)(de)(de)腰(yao)(yao)(yao)(yao)(yao)扭傷或感受(shou)風(feng)寒濕外邪等(deng)外因的(de)(de)(de)(de)作用下(xia)，發(fa)生(sheng)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出，當腰(yao)(yao)(yao)(yao)(yao)椎間(jian)(jian)盤(pan)(pan)(pan)突(tu)出壓(ya)迫的(de)(de)(de)(de)過于嚴(yan)重，對馬尾神經造成了(le)刺激(ji)，很多患者(zhe)(zhe)的(de)(de)(de)(de)癥(zheng)(zheng)(zheng)狀(zhuang)就(jiu)比較嚴(yan)重了(le)，這樣(yang)的(de)(de)(de)(de)患者(zhe)(zhe)會(hui)(hui)(hui)(hui)表現出明(ming)顯(xian)的(de)(de)(de)(de)大(da)小便失(shi)禁，會(hui)(hui)(hui)(hui)陰以及肛周的(de)(de)(de)(de)感覺出現麻木(mu)異常，有的(de)(de)(de)(de)患者(zhe)(zhe)甚(shen)至(zhi)會(hui)(hui)(hui)(hui)出現雙下(xia)肢的(de)(de)(de)(de)不(bu)(bu)完(wan)全癱瘓，腰(yao)(yao)(yao)(yao)(yao)間(jian)(jian)盤(pan)(pan)(pan)突(tu)出的(de)(de)(de)(de)癥(zheng)(zheng)(zheng)狀(zhuang)多種多樣(yang)，有的(de)(de)(de)(de)患者(zhe)(zhe)嚴(yan)重到甚(shen)至(zhi)不(bu)(bu)能進行正常的(de)(de)(de)(de)睡(shui)眠，平臥以后會(hui)(hui)(hui)(hui)出現明(ming)顯(xian)的(de)(de)(de)(de)疼痛，然而(er)(er)有的(de)(de)(de)(de)患者(zhe)(zhe)是平臥以后癥(zheng)(zheng)(zheng)狀(zhuang)會(hui)(hui)(hui)(hui)明(ming)顯(xian)的(de)(de)(de)(de)減輕甚(shen)至(zhi)消失(shi)，只要站立(li)或者(zhe)(zhe)是坐(zuo)位的(de)(de)(de)(de)時候，就(jiu)會(hui)(hui)(hui)(hui)出現明(ming)顯(xian)的(de)(de)(de)(de)疼痛。

重度血管性頭痛

血管性頭(tou)痛(tong)(tong)(tong)發(fa)(fa)作時(shi)常(chang)伴有(you)惡心(xin)(xin)、嘔吐、出汗、心(xin)(xin)悸、畏光等(deng)自主神(shen)經功能紊(wen)亂癥(zheng)狀(zhuang)。頭(tou)痛(tong)(tong)(tong)多(duo)呈(cheng)輕至中(zhong)度(du)(du)全頭(tou)痛(tong)(tong)(tong)、脹(zhang)痛(tong)(tong)(tong)，也可(ke)表現為枕部(bu)、額部(bu)、雙顳部(bu)疼痛(tong)(tong)(tong)，用腦、用力、活(huo)動頭(tou)部(bu)及(ji)改變體位時(shi)頭(tou)痛(tong)(tong)(tong)加(jia)重，常(chang)伴有(you)類似(si)神(shen)經衰弱癥(zheng)狀(zhuang)。也常(chang)發(fa)(fa)作呈(cheng)現明顯血管跳痛(tong)(tong)(tong)，惡心(xin)(xin)嘔吐，典型的(de)患(huan)者(zhe)發(fa)(fa)作前有(you)視力模糊，眼花表現。頭(tou)痛(tong)(tong)(tong)常(chang)發(fa)(fa)作于睡眠障(zhang)礙、情緒激動、過度(du)(du)疲勞(lao)、過量喝酒等(deng)之后，女性患(huan)者(zhe)在經期(qi)前后頭(tou)痛(tong)(tong)(tong)加(jia)重。

急性闌尾炎

單純(chun)性闌(lan)(lan)尾(wei)(wei)炎(yan)(yan)(yan)常(chang)呈陣發性或持續性脹痛(tong)(tong)和鈍痛(tong)(tong)，是(shi)普外科常(chang)見病(bing)和多發病(bing)，主(zhu)要的(de)表現(xian)就是(shi)右(you)下腹(fu)部疼(teng)痛(tong)(tong)，如果將疼(teng)痛(tong)(tong)分為10個(ge)等級，急性闌(lan)(lan)尾(wei)(wei)炎(yan)(yan)(yan)疼(teng)痛(tong)(tong)從最初(chu)的(de)單純(chun)性闌(lan)(lan)尾(wei)(wei)炎(yan)(yan)(yan)的(de)疼(teng)痛(tong)(tong)能達到3級或者(zhe)4級，如果闌(lan)(lan)尾(wei)(wei)炎(yan)(yan)(yan)不能夠有(you)效的(de)控制(zhi)或者(zhe)及時(shi)手術，甚至形成(cheng)了穿(chuan)孔、化膿和形成(cheng)腹(fu)膜炎(yan)(yan)(yan)時(shi)急性闌(lan)(lan)尾(wei)(wei)炎(yan)(yan)(yan)的(de)疼(teng)痛(tong)(tong)可能會迅速升級，有(you)的(de)嚴重的(de)會達到9級或者(zhe)10級左右(you)。

腎結石

腎(shen)結(jie)石是泌尿系(xi)統(tong)常見的疾(ji)病之一，而且容易復發，腎(shen)結(jie)石疼(teng)痛在醫(yi)學(xue)上被分(fen)為(wei)(wei)內臟(zang)疼(teng)痛，一般都(dou)是因為(wei)(wei)結(jie)石排(pai)泄過程中(zhong)導致輸尿管痙攣(luan)，腎(shen)臟(zang)積水，疼(teng)痛呈陣(zhen)發性(xing)絞(jiao)痛，疼(teng)痛向(xiang)下腹部(bu)膀胱區及(ji)后腰部(bu)放(fang)散(san)，同(tong)時有血尿，還伴有惡心(xin)嘔吐胃(wei)內容物(wu)。患(huan)者因疼(teng)痛輾(zhan)轉反側，痛不欲生。

牙神經痛

牙(ya)(ya)髓炎俗稱牙(ya)(ya)神經(jing)痛(tong)，柔軟(ruan)的(de)牙(ya)(ya)髓被堅硬的(de)牙(ya)(ya)釉質(zhi)(zhi)和(he)牙(ya)(ya)本質(zhi)(zhi)包圍著(zhu)，當炎癥發(fa)(fa)生時牙(ya)(ya)髓腔(qiang)內炎癥因(yin)子無(wu)處釋放，于是越來(lai)越擠，壓迫到(dao)了神經(jing)，便產生了痛(tong)不(bu)欲生的(de)感覺。表現為劇(ju)烈(lie)的(de)難以忍受的(de)疼(teng)(teng)痛(tong),疼(teng)(teng)痛(tong)的(de)性質(zhi)(zhi)有以下(xia)特點(dian)：自發(fa)(fa)性疼(teng)(teng)痛(tong)，陣發(fa)(fa)性加劇(ju)，呈間(jian)歇性發(fa)(fa)作，在(zai)無(wu)外(wai)界任何刺激的(de)情況下(xia)患牙(ya)(ya)發(fa)(fa)生劇(ju)烈(lie)疼(teng)(teng)痛(tong)，早期疼(teng)(teng)痛(tong)發(fa)(fa)作時間(jian)短(duan)(duan)，緩解時間(jian)較(jiao)(jiao)長(chang)，隨著(zhu)病情發(fa)(fa)展晚(wan)期則(ze)疼(teng)(teng)痛(tong)發(fa)(fa)作時間(jian)長(chang)，緩解時間(jian)較(jiao)(jiao)短(duan)(duan),乃至最(zui)后無(wu)緩解期。