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腰椎交感神经节切断术治疗复杂性区域疼痛综合征的疗效持续时间:一项前瞻性观察研究。

Effect duration of lumbar sympathetic ganglion neurolysis in patients with complex regional pain syndrome: a prospective observational study.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.

Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, South Korea.

出版信息

Sci Rep. 2024 Jun 3;14(1):12693. doi: 10.1038/s41598-024-63732-2.

Abstract

Lumbar sympathetic ganglion neurolysis (LSGN) has been used for long-term pain relief in patients with complex regional pain syndrome (CRPS). However, the actual effect duration of LSGN has not been accurately measured. This prospective observational study measured the effect duration of LSGN in CRPS patients and investigated the relationship between temperature change and pain relief. After performing LSGN, the skin temperatures of both the maximum pain site and the plantar area in the affected and unaffected limbs were measured by infrared thermography, and pain intensity was assessed before and at 2 weeks, 1 month, and 3 months. The median time to return to baseline temperature was calculated using survival analysis. The skin temperature increased significantly at all-time points relative to baseline in both regions (maximum pain site: 1.4 °C ± 1.0 °C, plantar region: 1.28 °C ± 0.8 °C, all P < 0.001). The median time to return to baseline temperature was 12 weeks (95% confidence interval [CI] 7.7-16.3) at the maximum pain site and 12 weeks (95% CI 9.4-14.6) at the plantar area. Pain intensity decreased significantly relative to baseline, at all-time points after LSGN. In conclusion, the median duration of the LSGN is estimated to be 12 weeks.

摘要

腰椎交感神经节切断术 (LSGN) 已被用于缓解复杂性区域疼痛综合征 (CRPS) 患者的长期疼痛。然而,LSGN 的实际效果持续时间尚未被准确测量。本前瞻性观察研究测量了 LSGN 在 CRPS 患者中的效果持续时间,并探讨了温度变化与疼痛缓解之间的关系。行 LSGN 后,采用红外热成像仪测量受累和未受累肢体的最大疼痛部位和足底区域的皮肤温度,并在术前、术后 2 周、1 个月和 3 个月评估疼痛强度。采用生存分析计算恢复到基线温度的中位时间。与基线相比,所有时间点两个区域的皮肤温度均显著升高(最大疼痛部位:1.4°C±1.0°C,足底区域:1.28°C±0.8°C,均 P<0.001)。最大疼痛部位恢复到基线温度的中位时间为 12 周(95%置信区间 [CI] 7.7-16.3),足底区域为 12 周(95% CI 9.4-14.6)。LSGN 后所有时间点的疼痛强度与基线相比均显著降低。总之,LSGN 的中位持续时间估计为 12 周。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfd1/11148052/662ecf4664cd/41598_2024_63732_Fig1_HTML.jpg

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