Soucacos P N, Diznitsas L A, Beris A E, Malizos K N, Xenakis T A, Papadopoulos G S
Department of Orthopedic Surgery, University of Ioannina, School of Medicine, Greece.
Acta Orthop Belg. 1998 Sep;64(3):314-21.
The effectiveness of a multimodal treatment protocol in the long-term management of upper extremity reflex sympathetic dystrophy (RSD), as well as of isolated finger involvement, was analyzed. In the present series, 62 patients diagnosed with RSD were treated and followed for a mean of 22.2 +/- 1.5 months. The findings in the present study indicate that: 1) RSD occurs predominantly in females (female:male, 3:1); 2) regional dystrophy is twice as common as segmental dystrophy; 3) segmental dystrophy is most often associated with minor traumatic dystrophy, whereas regional dystrophy is more evenly distributed among the various clinical types; 4) patients with regional dystrophy score their pain significantly higher; and 5) segmental and regional dystrophy respond with equal satisfaction to the multimodal treatment regimen. In conclusion, the weight of the available evidence strongly suggests that RSD is a complex multifaceted disease entity which responds well when managed with a multimodal treatment program aimed at the various interacting components of the disorder. Furthermore, the finding that segmental dystrophy did not behave differently from the treatment protocol compared to extensive upper extremity RSD, suggests that the anatomic location of the syndrome may not significantly alter the course of the disease during treatment.
分析了多模式治疗方案在长期治疗上肢反射性交感神经营养不良（RSD）以及单纯手指受累方面的有效性。在本系列研究中，62例被诊断为RSD的患者接受了治疗，并平均随访22.2±1.5个月。本研究的结果表明：1）RSD主要发生在女性中（女性：男性，3：1）；2）区域性营养不良的发生率是节段性营养不良的两倍；3）节段性营养不良最常与轻度创伤性营养不良相关，而区域性营养不良在各种临床类型中分布更为均匀；4）患有区域性营养不良的患者疼痛评分明显更高；5）节段性和区域性营养不良对多模式治疗方案的反应满意度相同。总之，现有证据有力地表明，RSD是一种复杂的多方面疾病实体，当采用针对该疾病各种相互作用成分的多模式治疗方案进行管理时，反应良好。此外，节段性营养不良与广泛上肢RSD相比，在治疗方案中的表现没有差异，这表明该综合征的解剖位置在治疗期间可能不会显著改变疾病进程。
