van Laere M, Claessens M
Rehabilitation Center, University Hospital of Ghent, Belgium.
Acta Orthop Belg. 1992;58 Suppl 1:259-61.
Reflex sympathetic dystrophy syndrome is the currently accepted term for a disorder that has previously appeared in the literature under a confusing array of designations: causalgia, Sudeck's atrophy, algoneurodystrophy, shoulder-hand syndrome, etc. The disorder, which was first described in 1864, is characterized by pain, swelling, limited range of motion with associated signs of vasomotor instability, trophic skin changes and patchy bone demineralization. It appears as an exaggerated response of an extremity to injury: trauma, infection, phlebitis or numerous other lesions. In 35 per cent of the RSDS patients, no precipitating event can be identified. The rational treatment of these patients should be based on a thorough understanding of its pathogenesis. While the optimal management is still controversial, there is a consensus that the best results will be achieved if treatment is started early and adapted to the clinical stage of the disease. The role of physical therapy is still debatable. Sympathetic interruption, corticosteroids, calcitonin, beta-blocking agents and more recently bi-phosphonates have been advocated. Proper management may result in the prevention of crippling sequelae.
反射性交感神经营养不良综合征是目前用于描述一种疾病的术语，该疾病在以往文献中曾以一系列令人困惑的名称出现：灼性神经痛、苏戴克萎缩症、痛性神经营养不良、肩手综合征等。这种疾病于1864年首次被描述，其特征为疼痛、肿胀、活动范围受限，并伴有血管舒缩不稳定、皮肤营养性改变和散在性骨质脱矿的体征。它表现为肢体对损伤（创伤、感染、静脉炎或许多其他损害）的过度反应。在35%的反射性交感神经营养不良综合征患者中，无法确定诱发事件。对这些患者的合理治疗应基于对其发病机制的透彻理解。虽然最佳治疗方案仍存在争议，但人们一致认为，如果早期开始治疗并根据疾病的临床阶段进行调整，将取得最佳效果。物理治疗的作用仍有争议。有人主张采用交感神经阻断、皮质类固醇、降钙素、β受体阻滞剂以及最近的双膦酸盐类药物。恰当的治疗可能会预防致残性后遗症。
