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[反射性交感神经营养不良:一例报告]

[Reflex sympathetic dystrophy: a case report].

作者信息

Kimura M, Suzuki N, Yoshino K

机构信息

Department of Pediatrics, National Nishitottori Hospital, Tottori.

出版信息

No To Hattatsu. 1995 Nov;27(6):487-91.

PMID:8534515
Abstract

We described an 11-year-old boy with reflex sympathetic dystrophy (RSD). He presented symptoms of allodynia and hyperesthesia in the right foot with pale color and coldness. Before the onset he had abdominal pain and a change of taste. The symptoms were resistant to physical therapy and the right foot became atrophic. Intermittent lumber epidural anesthesia by an indwelling catheter was performed for three weeks after 5 months from the onset. Improvement of symptoms did not occur during the anesthesia, but did soon after that. The pathogenesis of RSD remains unknown, although a psychological factor may have been involved in this case. RSD in childhood is usually considered to be more responsive to conservative therapy. However, some children such as our patient are resistant to conservative therapy. Recognition of RSD and early interventions such as physical therapy and psychological approach are important. In intractable cases invasive approaches such as sympathetic blockade should be also considered.

摘要

我们描述了一名患有反射性交感神经营养不良(RSD)的11岁男孩。他右脚出现了痛觉过敏和感觉异常症状,伴有足部皮肤苍白和发凉。发病前他有腹痛和味觉改变。这些症状对物理治疗有抵抗,右脚出现萎缩。发病5个月后,通过留置导管进行了为期3周的间歇性腰椎硬膜外麻醉。麻醉期间症状未改善,但之后很快出现了改善。尽管该病例可能涉及心理因素,但RSD的发病机制仍不清楚。儿童期的RSD通常被认为对保守治疗反应更好。然而,像我们的患者这样的一些儿童对保守治疗有抵抗。认识RSD并进行早期干预,如物理治疗和心理干预很重要。在难治性病例中,也应考虑诸如交感神经阻滞等侵入性治疗方法。

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