Veldman P H, Goris R J
Department of Surgery, University Hospital Nijmegen.
Unfallchirurg. 1995 Jan;98(1):45-8.
Surgery on extremities suffering from reflex sympathetic dystrophy (RSD) is generally avoided because it is presumed that RSD will recur or worsen. In order to study this problem we analyzed our patients. The affected limb of 47 patients suffering from RSD was operated on for various reasons. If possible, the operation was postponed until the signs and symptoms of RSD decreased at rest and perfusion of the affected limb was optimized; tourniquet haemostasis was avoided, and perioperative intravenous infusion of mannitol was administered. Recurrence of RSD was seen in 6 patients (13%). This recurrence was mild and temporary in 5 patients, but serious and permanent in 1 patient. Surgery on limbs suffering from RSD is not as dangerous as widely believed, but one should be aware of the risk of recurrence of RSD when surgery is being considered.
通常避免对患有反射性交感神经营养不良（RSD）的肢体进行手术，因为据推测RSD会复发或恶化。为了研究这个问题，我们对患者进行了分析。47例患有RSD的患者因各种原因对受影响的肢体进行了手术。如果可能，手术会推迟到RSD的体征和症状在休息时减轻且受影响肢体的灌注得到优化；避免使用止血带止血，并在围手术期静脉输注甘露醇。6例患者（13%）出现了RSD复发。5例患者的这种复发是轻微且暂时的，但1例患者的复发是严重且永久性的。对患有RSD的肢体进行手术并不像人们普遍认为的那么危险，但在考虑手术时应意识到RSD复发的风险。
