CRPS 的诊断和治疗» Suggested that the signs and symptoms of RSD may be caused by an exaggerated inflammatory response to injury or operation of an extremity.» Sudeck’s Atrophy: Bone loss associated with RSD» The syndrome much as we know it today˃Promoted the term RSD˃Described 3 st˃ages1994 年, IASP 正式采用“复杂性区域疼痛综合征”一词。指继发于意外损伤、医源性损伤或全身性疾病之后,出现的以严重顽固性、多变性疼痛,营养不良和功能障碍为特征的临床综合征。复杂性区域疼痛综合征( Complex Regional Pain Syndrome , CRPS )A variety of painful conditions following injury which appears regionally having a distal predominance of abnormal findings, exceeding in both magnitude and duration the expected clinical course of the inciting event, often resulting in significant impairment of motor function, and showing variable progression over time.» CRPS I: 21/100,000» CRPS II: 4 /100,000» 男:女 =3:1» 任何年龄均可发病,但中年人较多˃平均 42 岁» 骨折患者中 CRPS 的发病率约 1-2% » 周围神经损伤患者中 CRPS 的发病率约 2-5%根据对交感神经阻滞的反应:· 交感神经维持性疼痛( Sympathetically maintained pain , SMP )——对交感神经阻滞反应良好。· 交感神经无关性疼痛( Sympathetically independent pain , SIP )——对交感神经阻滞无反应。·ABC 综合征( Angry Backfiring C-nociceptor Syndrome )——交感神经阻滞后疼痛加重。 RSD — CRPSⅠ 型 小的损伤( minor trauma ),有神经损伤的可能性,但不能确定是什么神经受损。灼性神经痛 — CRPSⅡ 型 常有较明显且明确的神经损伤,大多数为交感神经维持性疼痛。1. 外伤是最常见的原因。扭挫伤、挤压伤、骨折等任何轻微的外伤,以腕、踝部多见。外伤轻重与是否引起 RSD 及病程之间无关。越是轻微的外伤反而越容易引起该病。 2. 医源性损伤固定石膏压迫软组织、腕踝部小手术、脊髓造影、注射或穿刺、手术切口、拔牙等。3. 其他疾病以心肌梗死、胸腔内疾患居多 - 上肢 RSD 常为四肢末梢神经干损伤后,引起持续性剧痛并伴有自主神经...