周围神经外科手术患者的标签复杂的区域性疼痛综合征在四肢
Floris V Raasveld1,2,3, Margaux Wolff2, Anna Luan4
1Division of Plastic and Reconstructive Surgery, Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Journal of the American College of Surgeons
|August 15, 2025
概括
综合区域疼痛综合征 (CRPS) 的管理具有挑战性. 周围神经手术改善了超过一半的CRPS患者的结果,突出了个性化,跨学科护理的需要.
科学领域:
- 疼痛管理 疼痛管理
- 神经学 神经学
- 手术干预 手术干预
背景情况:
- 综合区域疼痛综合征 (CRPS) 管理面临重大挑战.
- 对CRPS患者的最佳治疗途径尚不清楚.
- 本研究检查了CRPS诊断的患者的治疗轨迹.
研究的目的:
- 描述CRPS的标签所指的患者的治疗过程和结果.
- 为了确定与这种人群治疗改善相关的因素.
主要方法:
- 53名患有四肢CRPS标签的患者的回顾性分析 (2017-2024年).
- 使用布达佩斯标准将其分类为布达佩斯确认的CRPS,不确定的CRPS或非CRPS.
- 收集关于受伤,治疗和结果 (疼痛/功能改善) 的数据.
主要成果:
- 平均治疗持续时间为3.9年;常见的治疗包括神经调节剂,阿片类药物和外围神经外科手术 (66%).
- 总体临床改善为55%; 67%的手术患者报告有好处.
- 与改善相关的因素包括手术后转诊和缺乏情绪症状恶化.
结论:
- 超过一半的转诊CRPS患者接受了手术干预,报告有显著的益处.
- 调查结果强调需要跨学科,个性化的CRPS管理.
- 对于精选的CRPS患者,应考虑外围神经手术.
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