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复杂性区域疼痛综合征:流行病学、病理生理学、诊断和治疗的进展。

Complex regional pain syndrome: advances in epidemiology, pathophysiology, diagnosis, and treatment.

机构信息

Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.

Department of Health Sciences, Centre for Health and Wellbeing Across the Lifecourse, Brunel University London, Uxbridge, UK.

出版信息

Lancet Neurol. 2024 May;23(5):522-533. doi: 10.1016/S1474-4422(24)00076-0.

Abstract

Complex regional pain syndrome (CRPS) is a rare pain disorder that usually occurs in a limb after trauma. The features of this disorder include severe pain and sensory, autonomic, motor, and trophic abnormalities. Research from the past decade has offered new insights into CRPS epidemiology, pathophysiology, diagnosis, and treatment. Early identification of individuals at high risk of CRPS is improving, with several risk factors established and some others identified in prospective studies during the past 5 years. Better understanding of the pathophysiological mechanisms of CRPS has led to its classification as a chronic primary pain disorder, and subtypes of CRPS have been updated. Procedures for diagnosis have also been clarified. Although effective treatment of CRPS remains a challenge, evidence-based integrated management approaches provide new opportunities to improve patient care. Further advances in diagnosis and treatment of CRPS will require coordinated, international multicentre initiatives.

摘要

复杂性区域疼痛综合征(CRPS)是一种罕见的疼痛障碍,通常在创伤后发生于肢体。该疾病的特征包括严重疼痛以及感觉、自主神经、运动和营养异常。过去十年的研究为 CRPS 的流行病学、病理生理学、诊断和治疗提供了新的见解。目前已经确定了几种 CRPS 高危人群的早期识别方法,并且在过去 5 年的前瞻性研究中还发现了一些其他风险因素。对 CRPS 病理生理机制的更好理解导致其被归类为慢性原发性疼痛障碍,并且已经更新了 CRPS 的亚型。诊断程序也已得到澄清。尽管有效治疗 CRPS 仍然是一个挑战,但循证综合管理方法为改善患者护理提供了新的机会。进一步推进 CRPS 的诊断和治疗需要协调一致的国际多中心倡议。

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