Wang Yi-Chia, Li Hung-Yuan, Lin Feng-Sheng, Cheng Ya-Jung, Huang Chi-Hsiang, Chou Wei-Han, Huang Hsing-Hao, Lin Cheng-Chieh, Lin Che-Chen, Sung Fung-Chang, Wei Jung-Nan
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Pain Pract. 2015 Jul;15(6):548-53. doi: 10.1111/papr.12211. Epub 2014 May 7.
Few studies have investigated the relationship between injury location, mechanism and their association with complex regional pain syndrome (CRPS). We conducted a nationwide database survey to explore this issue.
This was a population-based case-control study. Five hundred and eighty-nine patients with at least one ambulatory visit or admission with a principal diagnosis of CRPS from 2004 to 2009 were selected. For each CRPS patient, ten age- and sex-matched non-CRPS subjects were randomly selected. The odds ratios (PLoS One. 2013;8:e57205) and 95% confidence intervals (95% CIs) of risk factors for CRPS were derived from multivariate logistic regression models.
Injury was a risk factor for CRPS (OR, 2.96; 95% CI, 2.18 to 4.02) independent of age and sex. In adjusted models, open wound on the upper limbs (OR 1.25, 95% CI 1.02 to 1.54) conferred higher CRPS risk. Injury mechanisms including nerve and spinal cord injury (OR 2.42, 95% CI 1.44 to 4.08), muscle and joint sprain and strain (OR 1.69, 95% CI 1.40 to 2.03), superficial injury (OR 1.23, 95% CI 1.00 to 1.51), and contusion (OR 1.44, 95% CI 1.20 to 1.74), but not fracture, increased the risk of CRPS.
Injury in the extremities rather than the trunk is an important risk factor for CRPS. Certain injury mechanisms confer higher risk of CRPS. This nationwide study demonstrated that injury increased CRPS nearly threefold. Open wound, sprain and strain, superficial injury, contusion, and nerve and spinal cord injury are main injury mechanisms. Injury in the extremities confers a higher risk of CRPS.
很少有研究调查损伤部位、机制及其与复杂性区域疼痛综合征（CRPS）的关联。我们进行了一项全国性数据库调查以探究此问题。
这是一项基于人群的病例对照研究。选取了2004年至2009年期间至少有一次门诊就诊或住院且主要诊断为CRPS的589例患者。对于每例CRPS患者，随机选取10名年龄和性别匹配的非CRPS受试者。CRPS危险因素的比值比（PLoS One. 2013;8:e57205）和95%置信区间（95%CI）来自多变量逻辑回归模型。
损伤是CRPS的一个危险因素（比值比，2.96；95%CI，2.18至4.02），与年龄和性别无关。在调整模型中，上肢开放性伤口（比值比1.25，95%CI 1.02至1.54）使CRPS风险更高。包括神经和脊髓损伤（比值比2.42，95%CI 1.44至4.08）、肌肉和关节扭伤及拉伤（比值比1.69，95%CI 1.40至2.03）、浅表损伤（比值比1.23，95%CI 1.00至1.51）和挫伤（比值比1.44，95%CI 1.20至1.74）但不包括骨折在内的损伤机制增加了CRPS风险。
四肢而非躯干的损伤是CRPS的一个重要危险因素。某些损伤机制使CRPS风险更高。这项全国性研究表明损伤使CRPS风险增加近三倍。开放性伤口、扭伤及拉伤、浅表损伤、挫伤以及神经和脊髓损伤是主要损伤机制。四肢损伤使CRPS风险更高。
