Rizzo Marco, Balderson S Scott, Harpole David H, Levin L Scott
Division of Orthopedic, Duke University Medical Center, Box 3945, Durham, NC 27710, USA.
Orthopedics. 2004 Jan;27(1):49-52. doi: 10.3928/0147-7447-20040101-18.
Complex regional pain syndrome, vasospastic disorders, and hyperhidrosis are chronic and debilitating upper extremity problems. Twenty-nine consecutive patients treated with thoracoscopic sympathectomy are presented. Diagnoses included complex regional pain syndrome, hyperhidrosis, Buerger's disease, Raynaud's disease, and peripheral vascular disease. All patients with hyperhidrosis had complete symptom resolution. Patients with Buerger's and Raynaud's disease had excellent/good results. Six patients with complex regional pain syndrome had excellent or good relief; the remaining six patients had varying degrees of recurrence. A statistically significant association was noted between duration of complex regional pain syndrome prior to sympathectomy and outcome. Thoracoscopic sympathectomy is an effective treatment for hyperhidrosis and vasospastic disorders. Although the results for complex regional pain syndrome are not uniformly excellent, this technique offers promise in the treatment of this difficult problem.
复杂性区域疼痛综合征、血管痉挛性疾病和多汗症是慢性且使人衰弱的上肢问题。本文介绍了连续29例接受胸腔镜交感神经切除术治疗的患者。诊断包括复杂性区域疼痛综合征、多汗症、血栓闭塞性脉管炎、雷诺病和周围血管疾病。所有多汗症患者症状均完全缓解。血栓闭塞性脉管炎和雷诺病患者疗效极佳/良好。6例复杂性区域疼痛综合征患者缓解极佳或良好；其余6例患者有不同程度的复发。胸腔镜交感神经切除术术前复杂性区域疼痛综合征的持续时间与预后之间存在统计学上的显著关联。胸腔镜交感神经切除术是治疗多汗症和血管痉挛性疾病的有效方法。虽然复杂性区域疼痛综合征的治疗结果并非都同样出色，但这项技术为治疗这一难题带来了希望。
