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成人复杂性局部疼痛综合征的病因、临床表现和诊断

Author
Salahadin Abdi, MD, PhD
Section Editors
Don L Goldenberg, MD
Ellen WK Rosenquist, MD
Deputy Editor
Paul L Romain, MD

引言

复杂性局部疼痛综合征(complex regional pain syndrome, CRPS)是一种身体局部(通常为肢体)的病症，其特征为疼痛、肿胀、活动度受限、血管舒缩不稳定、皮肤改变和斑片状骨矿物质流失。常始于创伤、外科手术或血管事件(如脑卒中)后。

CRPS在文献中有许多别名，包括反射性交感神经营养障碍(reflex sympathetic dystrophy, RSD)、痛性营养障碍、灼性神经痛、Sudeck萎缩、短暂性骨质疏松症和急性骨萎缩。脑卒中或心肌梗死后的上肢受累有时被称为“肩手综合征”。1993年，一场共识发展会议将这些疾病都归为一组，采用CRPS一种病名表示[1]。CRPS的诊断需要在有害事件后出现区域性疼痛和感觉变化。疼痛的严重程度大于激发损害的预期程度，疼痛常伴有皮肤颜色异常、温度变化、异常泌汗活动或水肿等发现。

公认CRPS有2种类型：

●Ⅰ型(又被称为RSD)，对应于无确定神经损伤的CRPS患者，约占临床的90%。

●Ⅱ型之前被称为灼性神经痛，是指存在明确的神经损伤的病例。

                   

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Literature review current through: 2017-06 . | This topic last updated: 2017-03-23.
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