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儿科复杂性区域疼痛综合征,伴或不伴起始时既往躯体创伤史。

Pediatric Complex Regional Pain Syndrome With and Without a History of Prior Physical Trauma at Onset.

机构信息

Division of Rheumatology, Department of Pediatrics, Children's Hospital of Philadelphia.

University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia.

出版信息

Clin J Pain. 2023 Sep 1;39(9):437-441. doi: 10.1097/AJP.0000000000001140.

Abstract

OBJECTIVE

To determine whether differences exist between children with complex regional pain syndrome (CRPS) who identify an inciting physical traumatic event (group T) versus those without such history (group NT).

METHODS

We performed a single-center, retrospective study of children diagnosed with CRPS, 18 years old or younger, presenting between April 2008 and March 2021 and enrolled in a patient registry. Abstracted data included clinical characteristics, pain symptoms, Functional Disability Inventory, psychological history, and Pain Catastrophizing scale for children. Charts were reviewed for outcome data.

RESULTS

We identified 301 children with CRPS, 95 (64%) reported prior physical trauma. There was no difference between the groups regarding age, sex, duration, pain level, function, psychological symptoms, and scores on the Pain Catastrophizing Scale for Children. However, those in group T were more likely to have had a cast (43% vs 23%, P < 0.001). Those in group T were less likely to experience complete resolution of symptoms (64% vs 76%, P = 0.036). There were no other outcome differences between the groups.

DISCUSSION

We found minimal differences in children with CRPS who report a prior history of physical trauma to those who do not. Physical trauma may not play as significant a role as immobility, such as casting. The groups mostly had similar psychological backgrounds and outcomes.

摘要

目的

确定是否存在有明确触发躯体创伤事件的儿童复杂性区域疼痛综合征(CRPS)患者(T 组)与无此类病史的患者(NT 组)之间的差异。

方法

我们进行了一项单中心、回顾性研究,纳入了 2008 年 4 月至 2021 年 3 月期间在患者注册中心被诊断为 CRPS 的 18 岁及以下儿童。提取的数据包括临床特征、疼痛症状、功能障碍指数、心理病史和儿童疼痛灾难化量表。对图表进行了回顾,以获取结局数据。

结果

我们共确定了 301 名 CRPS 患儿,其中 95 名(64%)患儿报告有先前的躯体创伤。两组间在年龄、性别、病程、疼痛水平、功能、心理症状和儿童疼痛灾难化量表评分方面均无差异。然而,T 组患儿更可能接受过石膏固定(43% vs 23%,P < 0.001)。T 组患儿症状完全缓解的可能性更低(64% vs 76%,P = 0.036)。两组间无其他结局差异。

讨论

我们发现,有明确躯体创伤史的 CRPS 患儿与无此类病史的患儿之间差异极小。躯体创伤可能不像石膏固定等制动那样起重要作用。两组患儿大多具有相似的心理背景和结局。

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