Reinauer S, Goerz G, Hölzle E, Heusgen F, Dinter W, Tarnow J, Ruzicka T
Hautklinik, Heinrich-Heine-Universität Düsseldorf.
Hautarzt. 1994 Oct;45(10):696-701. doi: 10.1007/s001050050152.
Reflex sympathetic dystrophy is characterized clinically by the triad of autonomic sympathetic dysfunction, and motor and sensory disturbances of the affected extremity. Typical symptoms are distal generalized edema with cyanotic skin, pathologic function of eccrine sweat glands and diffuse dull pain. If reflex sympathetic dystrophy is not recognized an irreversible stage may be reached, with atrophic pale, cool, and anhidrotic skin, contractures and diffuse osteoporosis. The syndrome can be idiopathic but can also be precipitated by a variety of factors, including banal trauma, bone fracture, and traumatic nerve lesions. Pathophysiologically, a functional disturbance of sympathetic nerve fibres may result in a vicious circle of blood flow dysfunction, excitation of afferent nociceptors and maintenance of sympathetic dysfunction at the level of the spinal or central nervous system. In the patient presented in this paper, sympathetic dysregulation of reflex sympathetic dystrophy was cured by means of blockades of the stellate ganglion.
反射性交感神经营养不良的临床特征为自主交感神经功能障碍、受累肢体的运动和感觉障碍三联征。典型症状为远端广泛性水肿伴皮肤发绀、小汗腺病理性功能障碍和弥漫性钝痛。如果反射性交感神经营养不良未被识别，可能会发展到不可逆阶段，出现皮肤萎缩、苍白、发凉和无汗、挛缩以及弥漫性骨质疏松。该综合征可为特发性，但也可由多种因素诱发，包括轻微创伤、骨折和创伤性神经损伤。在病理生理学上，交感神经纤维的功能障碍可能导致血流功能障碍、传入伤害感受器兴奋以及脊髓或中枢神经系统水平的交感神经功能障碍持续存在的恶性循环。在本文所介绍的患者中，通过星状神经节阻滞治愈了反射性交感神经营养不良的交感神经调节异常。
