当期文章

慢性术后疼痛的神经机制研究进展

王臆钦¹, 张文静^1,2, 耿武军^1,2, 刘明刚^1,*

¹瓯江实验室(再生调控与眼脑健康浙江省实验室)，温州 325000；²温州医科大学附属第一医院疼痛科，温州 325000

摘要

术后疼痛是手术创伤直接引发的常见并发症。流行病学研究表明，急性术后中至重度疼痛的发生率高达

术后疼痛是手术创伤直接引发的常见并发症。流行病学研究表明，急性术后中至重度疼痛的发生率高达41%~85%，其中约10%~50%的患者可能进一步发展为慢性疼痛。这不仅严重降低患者的生活质量，还会带来沉重的医疗和经济负担。慢性术后疼痛的发生机制极为复杂，涉及外周伤害感受器的激活与敏化，脊髓背角神经元的中枢敏化，以及高位皮层神经环路层面的异常改变。此外，手术损伤诱发的局部和系统性炎症反应，以及焦虑、抑郁、睡眠障碍等因素，也被证实在术后急性疼痛向慢性疼痛转化过程中发挥重要作用。本文旨在系统阐述术后疼痛的危险因素、动物模型、发生机制、治疗药物与干预策略的最新进展，重点关注从急性疼痛向慢性疼痛转化的关键环节和潜在干预靶点，以期为临床实践提供更加坚实的理论基础和循证依据。

关键词： 术后疼痛; 外周敏化; 中枢敏化; 神经环路

Research progress on neurobiological mechanisms of chronic postoperative pain

WANG Yi-Qin¹, ZHANG Wen-Jing^1,2, GENG Wu-Jun^1,2, LIU Ming-Gang^1,*

¹Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou 325000, China；²Department of Pain, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

Abstract

Postoperative pain is a common complication caused by surgical trauma. Epidemiological studies indicate that the incidence of moderate to severe acute postoperative pain ranges from 41% to 85%, with approximately 10% to 50% of patients potentially progressing to chronic pain. This progression not only significantly impairs patients' quality of life, but also imposes substantial medical and socioeconomic burdens. The mechanisms underlying chronic postoperative pain are highly complex, involving the activation and sensitization of peripheral nociceptors, central sensitization of spinal dorsal horn neurons, and maladaptive alterations in higher-order cortical neural circuits. Additionally, local and systemic inflammatory responses induced by surgical injury, and psychosocial factors, such as anxiety, depression, and sleep disturbances, have all been shown to play critical roles in the transition from acute to chronic postoperative pain. This article systematically reviews the latest advances in risk factors, animal models, pathophysiological mechanisms, and therapeutic strategies of postoperative pain, with particular emphasis on key processes and potential intervention targets involved in the transition from acute to chronic pain, aiming to offer a more solid theoretical foundation and evidencebased guidance for clinical practice.

Key words: postoperative pain; peripheral sensitization; central sensitization; neural circuit

收稿日期：　　录用日期：

通讯作者：刘明刚　　E-mail:

DOI: 10.13294/j.aps.2025.0111

引用本文：

王臆钦, 张文静, 耿武军, 刘明刚. 慢性术后疼痛的神经机制研究进展[J]. 生理学报 2026; 78 (1): 83-100.

WANG Yi-Qin, ZHANG Wen-Jing, GENG Wu-Jun, LIU Ming-Gang. Research progress on neurobiological mechanisms of chronic postoperative pain. Acta Physiol Sin 2026; 78 (1): 83-100 (in Chinese with English abstract).