SIGNS AND SYMPTOMS OF REFLEX SYMPATHETIC DYSTROPHY - PROSPECTIVE-STUDY OF 829 PATIENTS
SIGNS AND SYMPTOMS OF REFLEX SYMPATHETIC DYSTROPHY - PROSPECTIVE-STUDY OF 829 PATIENTS
复制标题
DOI：
10.1016/0140-6736(93)92877-v
复制
发表时间：
1993-10-23
期刊：
影响因子：
168.9
通讯作者：
GORIS, RJA
中科院分区：
文献类型：
--
作者：
VELDMAN, PHJM;REYNEN, HM;GORIS, RJA
反射性交感神经营养不良（又称Sudeck氏萎缩、causalgia、algodystrophy和peripheral trophoneurosis）的发病机制尚不清楚，诊断和治疗患者也很困难。我们对829例患者进行了前瞻性研究，特别注意早期体征和症状。在其早期阶段，反射性交感神经营养不良的特征是局部炎症，在肌肉运动后增加。93%的患者存在疼痛，69%和75%的患者分别存在感觉减退和过敏。随着时间的推移，可能会出现组织萎缩以及不自主运动、肌肉痉挛或假性麻痹。49%的患者有震颤，54%的患者有肌肉不协调。交感症状如多汗症并不常见，因此没有诊断价值。我们没有发现与该疾病存在三个连续阶段相一致的证据。早期症状是炎症反应，而不是交感神经系统紊乱。这些数据支持了反射性交感神经营养不良患者对损伤或手术的过度区域炎症反应的概念。
The pathogenesis of reflex sympathetic dystrophy-variously known as Sudeck's atrophy, causalgia, algodystrophy, and peripheral trophoneurosis-is not yet understood, and diagnosing and treating patients is difficult.We have prospectively studied 829 patients, paying particular attention to early signs and symptoms. In its early phase, reflex sympathetic dystrophy is characterised by regional inflammation, which increases after muscular exercise. Pain was present in 93% of patients, and hypoaesthesia and hyperpathy were present in 69% and 75% respectively. With time, tissue atrophy may occur as well as involuntary movements, muscle spasms, or pseudoparalysis. Tremor was found in 49% and muscular incoordination in 54% of patients. Sympathetic signs such as hyperhidrosis are infrequent and therefore have no diagnostic value. We found no evidence consistent with the presence of three consecutive phases of the disease. Early symptoms are those of an inflammatory reaction and not of a disturbance of the sympathetic nervous system.These data support the concept of an exaggerated regional inflammatory response to injury or operation in reflex sympathetic dystrophy.