Vescio Andrea, Testa Gianluca, Culmone Annalisa, Sapienza Marco, Valenti Fabiana, Di Maria Fabrizio, Pavone Vito
Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy.
Children (Basel). 2020 Nov 20;7(11):245. doi: 10.3390/children7110245.
Complex regional pain syndrome (CRPS) is characterized by chronic, spontaneous and provoked pain of the distal extremities whose severity is disproportionate to the triggering event. Diagnosis and treatment are still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age.
Data extraction was performed independently by three reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the Newcastle-Ottawa Quality Assessment Scale Cohort Studies.
At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), associated with cognitive behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT + CBT shows the most efficacy as suggested, but a commonly accepted protocol has not been developed.
Physical therapy in association with occupational and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested.
复杂性区域疼痛综合征（CRPS）的特征是远端肢体出现慢性、自发性和诱发性疼痛，其严重程度与触发事件不成比例。诊断和治疗仍存在争议且需要多学科参与。本系统评价的目的是分析现有文献，以提供有关生长发育期CRPS治疗的最新证据。
由三位评价者根据预定义标准独立进行数据提取，并采用纽卡斯尔-渥太华质量评估量表队列研究对纳入研究的方法学质量进行量化。
在首次筛选结束时，按照先前描述的选择标准，我们选择了n = 103篇符合全文阅读条件的文章。最终，经过全文阅读和参考文献列表检查，我们选择了n = 6篇文章。这些文章聚焦于物理治疗（PT），以及与认知行为治疗（CBT）和药物治疗（PhT）相结合的治疗方法。如所建议的，PT + CBT的联合治疗显示出最大疗效，但尚未制定出普遍接受的方案。
物理治疗与职业和认知行为治疗相结合是小儿CRPS管理中的推荐选择。药物治疗应保留给难治性和特定患者。强烈建议设计和制定标准方案。
