Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Türkocağı street No:3, Sıhhiye, Ankara, Turkey.
Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Türkocağı street No:3, Sıhhiye, Ankara, Turkey.
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):104995. doi: 10.1016/j.jstrokecerebrovasdis.2020.104995. Epub 2020 Jul 3.
In this study, it is aimed to determine the risk factors associated with CRPS after stroke and the clinical parameters of the patients and the treatment agents used for CPRS METHOD: 213 hemiplegic patients with CRPS diagnosed in Group 1 and 213 hemiplegic patients without CRPS in group 2 (control group) were included in the study designed retrospectively. Demographic data of the patients, Brunnstrom stage, Modified Ashworth scale, Barthel index were recorded from patients files. Associated risk faktors with CRPS such as Shoulder subluxation, adhesive capsulitis, fracture, deep vein thrombosis, spasticity, neglect, visual field defect, heterotopic ossification, entrapment neuropathies, brachial plexus damage, pressure wound, lower respiratory tract infection (LRTI), urinary tract infection, epilepsy, and depression were questioned. In addition, clinical findings, medical treatments, and physical therapy agents used were recorded.
The average age of the participants was 67.9 ± 10.3 in group 1 and 66.1 ± 9.9 in group 2. According to the multivariate logistic regression analysis, the presence of the duration of hemiplegi, the duration of hospitalization, shoulder subluxation, soft tissue lesion, adhesive capsulitis, spasticity, entrapment neuropathy, brachial plexus ınjury, protein energy malnutrition, LRTI, urinary infection, depression, coronary artery disease were significantly increased the development of CRPS (p<0.05). As a clinical parameter, edema was present in 95.3% of the patients, while trophic change was the lowest in 1.9%. While sensory reeducation was used in all patients in physical therapy, ganglion blockade was the lowest with 0.9% of patients. In medical treatment, the use of oral paracetamol was 28.2%, while the use of gabapentin was the last with 8.9%.
In our study, the risk factors of CRPS after hemiplegia, which are as important as its treatment, as well as its diagnosis and prevention, are shown.
本研究旨在确定中风后复杂性区域疼痛综合征（CRPS）的相关风险因素，以及患者的临床参数和用于治疗 CRPS 的药物。
本回顾性研究纳入了 213 例确诊为 CRPS 的偏瘫患者（1 组）和 213 例无 CRPS 的偏瘫患者（对照组）。从患者的病历中记录了患者的人口统计学数据、Brunnstrom 分期、改良 Ashworth 量表、Barthel 指数。同时还询问了与 CRPS 相关的风险因素，如肩关节半脱位、粘连性囊炎、骨折、深静脉血栓形成、痉挛、忽视、视野缺损、异位骨化、神经卡压、臂丛损伤、压疮、下呼吸道感染（LRTI）、尿路感染、癫痫和抑郁等。此外，还记录了患者的临床发现、治疗方法和物理治疗药物。
1 组患者的平均年龄为 67.9±10.3 岁，2 组患者的平均年龄为 66.1±9.9 岁。多变量逻辑回归分析显示，偏瘫持续时间、住院时间、肩关节半脱位、软组织损伤、粘连性囊炎、痉挛、神经卡压、臂丛损伤、蛋白质能量营养不良、LRTI、尿路感染、抑郁、冠心病等因素均显著增加了 CRPS 的发生风险（p<0.05）。作为临床参数，95.3%的患者存在水肿，而营养改变的发生率最低，为 1.9%。在物理治疗中，所有患者均接受了感觉再教育，而神经节阻滞的使用率最低，为 0.9%。在药物治疗中，口服扑热息痛的使用率为 28.2%，加巴喷丁的使用率最低，为 8.9%。
在本研究中，我们展示了偏瘫后 CRPS 的风险因素，这些因素与治疗同样重要，对于 CRPS 的诊断和预防具有重要意义。
