Shumacker H B
Ann Surg. 1985 Mar;201(3):278-89. doi: 10.1097/00000658-198503000-00004.
This is a personal assessment of true major causalgia and the other reflex dystrophies, related but distinctly separate entities. The clinical picture of causalgia differs only in minor respects from that described by Mitchell over 120 years ago. Its management has, however, been clarified, largely through the extensive experiences of World War II. It is readily recognized and can be treated effectively by sympathetic blocks or sympathectomy together with active exercise. The other reflex dystrophies are far less understood. They appear to have a similar pattern in their early phase and to respond well to a program of exercise and control of edema--a regimen which, because of pain and paresis, cannot be carried out without sympathetic blocks or occasionally sympathectomy. When not recognized early and treated properly, the sympatomatology usually changes dramatically and treatment differs. Often control of edema and active use of the affected part are all that is necessary. Sometimes, in addition to these measures, sympathetic blocks or sympathectomy is required. Guidelines found useful in management are outlined. Puzzling features are discussed.
这是对真性灼性神经痛及其他反射性交感神经营养不良（相关但截然不同的病症）的个人评估。灼性神经痛的临床表现与120多年前米切尔所描述的相比，仅有细微差别。然而，其治疗方法已得到明确，这在很大程度上得益于第二次世界大战的丰富经验。它很容易被识别，通过交感神经阻滞或交感神经切除术并结合主动运动能够得到有效治疗。而其他反射性交感神经营养不良则远未被充分了解。它们在早期似乎有相似的模式，并且对运动计划和水肿控制反应良好——由于疼痛和麻痹，若无交感神经阻滞或偶尔的交感神经切除术，该治疗方案便无法实施。若未早期识别并妥善治疗，症状通常会发生显著变化，治疗方法也会不同。通常控制水肿并积极使用患部就足够了。有时，除了这些措施外，还需要交感神经阻滞或交感神经切除术。文中概述了在治疗中发现有用的指导原则。对一些令人困惑的特征进行了讨论。
