前臂外伤术后复杂性区域疼痛综合征恢复期康复治疗效果的影响因素分析

Analysis of factors influencing prognosis of complex regional pain syndrome after forearm trauma surgery during rehabilitation stage

目的:通过对前臂外伤术后复杂性区域疼痛综合征(complex regional pain syndrome,CRPS)恢复期患者康复治疗效果的影响因素研究,探讨改善前臂外伤术后CRPS患者预后的干预方式.方法:对131例首次前臂外伤术后4个月内CRPS患者日常生活活动能力(ADL,Activities of Daily Living)与患者病程、年龄等12项可能相关因素进行调查、评估,采用逐步多重线性回归分析法进行分析,筛选影响CRPS患者ADL康复治疗效果的影响因素.结果:影响CRPS患者ADL治疗效果的多因素分析:进入回归方程的变量共有6个,复相关系数为0.738,结果显示年龄、病程、性别呈负相关,亦即年龄小的CRPS患者治疗效果好,病程短的CRPS患者ADL治疗效果好,男性患者ADL治疗效果好;肌腱损伤、神经损伤、治疗方式则呈正相关,无神经损伤、无肌腱损伤、综合治疗的CRPS患者ADL治疗效果好.结论:影响前臂外伤术后CRPS患者恢复期ADL治疗效果的相关因素涉及患者年龄、病程、性别、有无肌腱损伤、有无神经损伤、治疗方式,而对于这些因素的干预是提高前臂外伤术后CRPS患者ADL治疗效果的重要手段.

Objective:To find out influence factors of recovery effect of complex regional pain syndrome after forearm trauma surgery during rehabilitation stage.To discuss how to intervene to improve prognosis of CRPS.Methods:one hundred and thirty-one patients within 4 months were involved in this study.Their ADL(Activities of Daily Living)and twelve factors,such as patient's disease course,age were recorded and analyzed with multiple linear regression analysis,and the influence factor were screening.The scales included ADL.Results:The influence factor of hand ADL in individuals with CRPS during rehabilitation stage include six aspects,such as age,patient disease course,gender,presence or absence of nerve injury,presence or absence of tendon injury,treatment protocol.The young CRPS patients had good treatment effect,the short course of CRPS patients had good ADL treatment effect,and the male patients had good ADL treatment effect,CRPS patients with comprehensive treatment and without nerve injury,tendon injury had more effective ADL treatment.Conclusion:The influence factors includes many aspects,including physical psychological and social factors.The interventions for these influence factors were important means for alleviating pain and improving ADL of CRPS patients.