Gay A-M, Béréni N, Legré R
Service de chirurgie de la main et réparatrice des membres, hôpital La-Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France.
Chir Main. 2013 Oct;32(5):269-80. doi: 10.1016/j.main.2013.07.011. Epub 2013 Sep 21.
First described by Ambroise Paré in the mid-17th century complex, regional pain syndrome (CRPS) can be defined as an articular and periarticular pain syndrome associated with vasomotor deregulation triggered by various stresses with no relationship between the intensity of the initial injury and severity of the continuing pain. Several names have been given to Type 1 complex regional pain syndrome (CRPS-I): causalgia, reflex sympathetic dystrophy, shoulder-hand syndrome and algodystrophy. The reported incidence of CRPS-I is about 25 per 100,000. Predisposing factors are tobacco consumption and being female (W/M ratio=4). Although all the limbs can be affected, the upper limb is by far the most affected. CRPS-I is a classic complication of distal radius fractures (4-37%) and carpal tunnel surgery (2-4%). Early diagnosis and management are the most important elements of treatment because this syndrome has a long and disabling course. Some of the proposed treatments include NSAIDs, antidepressants and anticonvulsants. The latter, despite their good analgesic effects, do not cure CRPS-I. In select cases, a surgical procedure aiming at removing a nociceptive stimulus can lead to spectacular improvements.
复杂区域疼痛综合征（CRPS）最早由安布鲁瓦兹·帕雷于17世纪中叶描述，可定义为一种关节及关节周围疼痛综合征，与各种应激引发的血管舒缩失调相关，初始损伤的严重程度与持续疼痛的严重程度之间并无关联。1型复杂区域疼痛综合征（CRPS-I）有多个名称：灼性神经痛、反射性交感神经营养不良、肩手综合征和痛性营养不良。据报道，CRPS-I的发病率约为每10万人中有25例。诱发因素包括吸烟和女性（男女比例为4）。虽然四肢均可受累，但上肢受累最为常见。CRPS-I是桡骨远端骨折（4%-37%）和腕管手术（2%-4%）的典型并发症。早期诊断和治疗是治疗的最重要环节，因为该综合征病程漫长且会导致残疾。一些建议的治疗方法包括使用非甾体抗炎药、抗抑郁药和抗惊厥药。尽管抗惊厥药止痛效果良好，但无法治愈CRPS-I。在某些特定病例中，旨在消除伤害性刺激的手术可带来显著改善。
