Domerchie Patrick N, Dijkstra Pieter U, Geertzen Jan H B
University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Rehabil Med Clin Commun. 2023 May 25;6:7789. doi: 10.2340/jrmcc.v6.7789. eCollection 2023.
Complex Regional Pain Syndrome type I (CRPS-I) is an often intractable regional pain syndrome, usually affecting limbs in which amputation may be a final resort. Not all patients are suited for amputation.This retrospective case series with explorative interviews aims to gain insight in the quality of life in those who have been denied an amputation and their functioning with CRPS-I.
Between 2011 and 2017, 37 patients were denied an amputation. Participants were interviewed regarding quality of life, treatments received since their outpatient clinic visit and their experiences at our outpatient clinic.
A total of 13 patients participated. Most patients reported improvements in pain, mobility and overall situation. All patients received treatments after being denied an amputation, with some reporting good results. Many felt they had no part in decision making. Of the 13 participants 9 still had an amputation wish. Our participants scored worse in numerous aspects of their lives compared with patients with an amputation from a previous CRPS-I study of us.
This study shows that amputation should only be considered after all treatments have been tried and failed, since most participants reported improvements in aspects of their functioning over time.
I型复杂性区域疼痛综合征（CRPS-I）是一种常难以治疗的区域性疼痛综合征，通常累及四肢，截肢可能是最终手段。并非所有患者都适合截肢。本项带有探索性访谈的回顾性病例系列研究旨在深入了解那些被拒绝截肢的患者的生活质量以及他们CRPS-I的功能状况。
2011年至2017年期间，37例患者被拒绝截肢。就生活质量、自门诊就诊以来接受的治疗以及他们在我们门诊的经历对参与者进行了访谈。
共有13例患者参与。大多数患者报告疼痛、活动能力和总体状况有所改善。所有患者在被拒绝截肢后都接受了治疗，一些患者报告效果良好。许多人觉得他们没有参与决策过程。13名参与者中有9人仍有截肢意愿。与我们之前一项CRPS-I研究中接受截肢的患者相比，我们的参与者在生活的许多方面得分更低。
本研究表明，只有在所有治疗都尝试且失败后才应考虑截肢，因为大多数参与者报告随着时间推移其功能状况的各个方面都有所改善。
