Morros C, Cedo F
Servico de Anestesiología, Reanimación y Terapia del Dolor, Mutua Metalúrgica de Accidentes de Trabajo, Barcelona.
Rev Esp Anestesiol Reanim. 1994 Sep-Oct;41(5):288-91.
To assess the results obtained in treatment of sympathetic reflex dystrophy by sympathetic endovenous blockades with reserpine in working patients. We reviewed 170 diagnoses of sympathetic reflex dystrophy in 165 patients. One hundred seven were located in the foot, 13 were in the knee and 50 were in the hand. All were treated once a week for 3 weeks with local sympathetic endovenous blocks with reserpine (1 mg in the upper extremity and 1.5 mg in the lower extremity). We analyzed the location, etiology, course, X-rays, gammagrams, psychological state, other treatments, associated conditions, number of blocks received and side effects. The results were classified as excellent, good, fair and nil. We particularly reviewed sympathetic reflex dystrophy associated to Colles' fractures. Five hundred forty endovenous sympathetic blocks with reserpine were performed. Results obtained were excellent in 57 (34%) patients, good in 77 (45%), fair in 29 (17%) and nil in 7 (4%). Sympathetic reflex dystrophy leads to loss of 215 +/- 91 working days. In patients with Colles' fracture without sympathetic reflex dystrophy the loss is 96 +/- 31 days, although this period lengthens to 115 +/- 15 days if the two conditions are associated in stage I and to loss of 193 +/- 71 days if the association is in stage II. Results of treating sympathetic reflex dystrophy with sympathetic endovenous blocks with reserpine are satisfactory, particularly when diagnosis and treatment are early, clearly demonstrating the usefulness of this technique in workplace medicine.
评估在职患者中使用利血平进行交感神经静脉阻滞治疗交感反射性营养不良的效果。我们回顾了165例患者的170例交感反射性营养不良诊断病例。其中107例位于足部，13例位于膝部，50例位于手部。所有患者均每周接受一次局部交感神经静脉阻滞治疗，共治疗3周，使用利血平（上肢1mg，下肢1.5mg）。我们分析了病变部位、病因、病程、X线、γ线扫描、心理状态、其他治疗方法、相关疾病、接受阻滞的次数及副作用。结果分为优、良、中、差。我们特别回顾了与科雷氏骨折相关的交感反射性营养不良。共进行了540次利血平交感神经静脉阻滞。结果显示，57例（34%）患者为优，77例（45%）为良，29例（17%）为中，7例（4%）为差。交感反射性营养不良导致损失215±91个工作日。在无交感反射性营养不良的科雷氏骨折患者中，损失为96±31天，但若在I期同时存在这两种情况，这一时期会延长至115±15天，若在II期合并则损失为193±71天。用利血平进行交感神经静脉阻滞治疗交感反射性营养不良的效果令人满意，尤其是在早期诊断和治疗时，清楚地证明了该技术在职业医学中的实用性。
