Signs and symptoms in complex regional pain syndrome type I/Reflex sympathetic dystrophy: Judgment of the physician versus objective measurement
Signs and symptoms in complex regional pain syndrome type I/Reflex sympathetic dystrophy: Judgment of the physician versus objective measurement
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DOI：
10.1097/00002508-199909000-00010
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发表时间：
1999-09-01
影响因子：
2.9
通讯作者：
Goris, RJA
中科院分区：
文献类型：
--
作者：
Oerlemans, HM;Oostendorp, RAB;Goris, RJA
目的：探讨复杂区域疼痛综合征I型（CRPS I）主观上评估与客观测量的诊断体征和症状的关系，并量化其严重程度。设计：记录单侧上肢CRPS 1期患者的诊断体征和症状，时间不超过1年。独立评估者通过四种视觉模拟量表（VAS）和McGill问卷形容词表（MPQ）测量(a)疼痛，(b)用手体积计测量水肿，(c)用红外温度计测量皮肤温度，(d)用测角仪测量主动活动范围（AROM）。环境：两所大学医院。患者：女性95例，男性40例，单侧上肢CRPSⅰ型。结果：50例患者诊断出4种体征和症状，其余85例患者诊断出5种体征和症状，当前疼痛强度平均评分为31.5 mm，运动引起的疼痛平均评分为71.9 mm。MPQ的中位数为11.5个单词，其中评价部分的单词数最多。两只手的体积差为30.4 ml。两只手的平均温度差为0.78℃，手掌的平均温度差为0.66℃。活动能力下降最大的部位是手腕和手指；与其他手指相比，拇指受影响相对较小，小指受影响相对较大。结论：采用Veldman标准对CRPS I的床边评价与这些标准的心理测量或实验室测试结果吻合良好。
Objective: To assess the relation between the subjectively assessed and objectively measured diagnostic signs and symptoms in complex regional pain syndrome type I (CRPS I) and to quantify their severity.Design: Diagnostic signs and symptoms were recorded in patients suffering from CRPS I of one upper extremity for less than 1 year. Independent assessors measured (a) pain by using four visual analog scales (VAS) and the McGill Questionnaire list of adjectives (MPQ), (b) edema with a hand volumeter, (c) skin temperature with an infrared thermometer, and (d) active range of motion (AROM) with goniometers.Setting: Two university hospitals.Patients: Ninety-five women and 40 men with CRPS I of one upper extremity.Results: Four signs and symptoms were diagnosed in 50 patients, and five in the remaining 85 patients, The mean score for present pain intensity was 31.5 mm and that for pain resulting from exertion of the affected extremity was 71.9 mm. A median of 11.5 words was chosen from the MPQ, with the highest number from its evaluative part. The difference in volume between both hands was 30.4 ml. The mean difference in temperature between the two hands was 0.78 degrees C dorsally and 0.66 degrees C palmarly. The largest decrease in mobility was seen in the wrist and fingers; the thumb was relatively less affected and the little finger relatively more affected than the other fingers.Conclusions: Bedside evaluation of CRPS I with Veldman's criteria was in good accord with psychometric or laboratory testing of these criteria.