Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands. E-mail:
J Rehabil Med. 2020 Aug 24;52(8):jrm00087. doi: 10.2340/16501977-2718.
To assess long-term outcomes of amputation in patients with long-standing therapy-resistant complex regional pain syndrome type I (CRPS-I).
Partly cross-sectional, partly longitudinal study.
Patients who had amputation of a limb due to long-standing, therapy-resistant CRPS-I, at the University Medical Centre Groningen, The Netherlands, between May 2000 and September 2015 (n = 53) were invited to participate.
Participants were interviewed in a semi-structured way regarding mobility, pain, recurrence of CRPS-I, quality of life, and prosthesis use. Those who reported recurrence of CRPS-I underwent physical examination.
A total of 47 patients (median age at time of amputation, 41.0 years; 40 women) participated. Longitudinal evaluation was possible in 17 participants. Thirty-seven participants (77%) reported an important improvement in mobility (95% confidence interval (95% CI) 63; 87%). An important reduction in pain was reported by 35 participants (73%; 95% CI 59; 83%). CRPS-I recurred in 4 of 47 participants (9%; 95% CI 3; 20%), once in the residual limb and 3 times in another limb. At the end of the study of the 35 participants fitted with a lower limb prosthesis, 24 were still using the prosthesis. Longitudinal evaluation showed no significant deteriorations.
Amputation can be considered as a treatment for patients with long-standing, therapy-resistant CRPS-I. Amputation can increase mobility and reduce pain, thereby improving the quality of patients' lives. However, approximately one-quarter of participants reported deteriorations in intimacy and self-confidence after the amputation.
评估长期治疗抵抗性慢性复杂性区域疼痛综合征 I 型（CRPS-I）患者截肢的长期结果。
部分为横断面研究，部分为纵向研究。
荷兰格罗宁根大学医学中心 2000 年 5 月至 2015 年 9 月间因长期治疗抵抗性 CRPS-I 而行肢体截肢的患者（n=53）被邀请参加研究。
采用半结构化访谈的方式对患者进行访谈，了解其移动能力、疼痛、CRPS-I 复发、生活质量和义肢使用情况。报告 CRPS-I 复发的患者接受了体格检查。
共 47 名患者（截肢时的中位年龄为 41.0 岁，40 名女性）参与了研究。17 名参与者进行了纵向评估。37 名参与者（77%）报告移动能力有重要改善（95%置信区间 95%CI 63%；87%）。35 名参与者（73%；95%CI 59%；83%）报告疼痛有重要减轻。47 名参与者中有 4 名（9%；95%CI 3%；20%）发生 CRPS-I 复发，1 例发生在残肢，3 例发生在另一条肢体。在 35 名安装下肢义肢的参与者的最终研究中，24 名仍在使用义肢。纵向评估未显示显著恶化。
对于长期治疗抵抗性 CRPS-I 患者，截肢可被视为一种治疗方法。截肢可以增加移动能力和减轻疼痛，从而提高患者的生活质量。然而，约四分之一的参与者报告截肢后亲密关系和自信心恶化。
