Zyluk A
Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
Acta Orthop Belg. 1998 Sep;64(3):309-13.
One hundred twelve patients with posttraumatic reflex sympathetic dystrophy were treated using 4 methods: regional intravenous blocks with lignocaine and methylprednisolone, mannitol i.v. (free-radical scavenger), calcitonin i.m. and physical therapy (program of exercises). Good results occurred in 73 cases (65%), moderate in 27 (24%) and poor results (persistence of spontaneous pain and/or malfunction of the hand) in 12 (11%). The method of treatment had no significant influence on the frequency of poor results. The following factors were analyzed in order to assess their influence on the results of the treatment: age, sex, psychological status, type and severity of the initial injury, duration and stage of the disease, initial deficiency of finger flexion, presence of changes on x ray and bone scans; the results were subjected to statistical analysis ("z" test comparing frequency for two independent trials). The incidence of poor results was significantly higher in patients with duration of reflex sympathetic dystrophy longer than 12 months, in the second and third stages of disease, and in cases with coexisting nerve injuries or compression as a consequence of initial trauma. The other factors analyzed had no significant influence on the unfavourable result of the treatment of reflex sympathetic dystrophy.
112例创伤后反射性交感神经营养不良患者采用4种方法进行治疗：利多卡因和甲基强的松龙区域静脉阻滞、静脉注射甘露醇（自由基清除剂）、肌肉注射降钙素以及物理治疗（锻炼方案）。73例（65%）取得良好效果，27例（24%）效果中等，12例（11%）效果不佳（仍存在自发痛和/或手部功能障碍）。治疗方法对不佳效果的发生率无显著影响。为评估以下因素对治疗效果的影响进行了分析：年龄、性别、心理状态、初始损伤的类型和严重程度、疾病持续时间和阶段、初始手指屈曲功能缺陷、X线和骨扫描的改变情况；对结果进行了统计分析（采用“z”检验比较两个独立试验的频率）。反射性交感神经营养不良持续时间超过12个月的患者、疾病的第二和第三阶段患者以及因初始创伤并存神经损伤或受压的患者，不佳效果的发生率显著更高。分析的其他因素对反射性交感神经营养不良治疗的不良结果无显著影响。
