对1例肩袖损伤术后并发复杂性区域疼痛综合征患者的康复治疗  

Rehabilitation of complex regional pain syndrome after arthroscopic rotator cuff repair:case report

作　　者：从洋洋 邱晓 高天昊 黄崧华 赵娟 白玉龙 CONG Yangyang;QIU Xiao;GAO Tianhao;HUANG Songhua;ZHAO Juan;BAI Yulong(Department of Rehabilitation,Northern Division of Huashan Hospital,Fudan University,Shanghai 201907,China;Department of Rehabilitation,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院北院康复医学科,上海201907 [2]复旦大学附属华山医院康复医学科,上海200040

出　　处：《上海医药》2021年第9期3-5,42,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市宝山区科学技术委员会科技创新专项资金项目(17-E-31);上海市卫生健康委员会科研课题(20204Y0442)。

摘　　要：对1例右肩袖损伤术后并发复杂性区域疼痛综合征(complex regional pain syndrome, CRPS)患者,采用以上肢运动疗法为主的综合康复治疗方法(包括关节松动、肌力训练、镜像疗法和手法淋巴引流等)治疗8个月,结果患者的症状和功能均获显著改善:疼痛的视觉模拟量表评分由7分降至0分;右手背轻触觉、两点辨别觉由障碍恢复至正常;右侧手指周径由较健侧手指粗0.5~0.7 mm降至粗0.1~0.2 mm;右侧肩、肘、腕、手的徒手肌力试验评级由3、4、3、3级提高到5、5、5、5级;右侧肩部、手部活动的受限程度得到较大改善;Barthel指数评分由80分提高到100分;CRPS严重程度量表评分由12分降至1分。综合康复治疗对肩袖损伤术后并发CRPS患者的效果较好,患者已回归正常的家庭生活。A patient with complex regional pain syndrome(CRPS)after rotator cuff repair was treated with comprehensive rehabilitation training based on the upper limb movement therapy including joint loosening,muscle training,mirror therapy,technique lymph abstinence and so on for 8 months.As a result,the patient’s symptoms and function were significantly improved,in which the scores of Visual Analogue Scale were reduced from 7 to 0,the sense of light touch and the discrimination of two points on the back of right hand were returned from obstacles to normal,the circumference of the right finger was decreased from 0.5-0.7 mm to 0.1-0.2 mm compared with that of the healthy finger.The scores of manual muscle testing of right shoulder,elbow,wrist and hand were increased from 3,4,3,3 to 5,5,5,5,respectively,and the degree of restriction of the right shoulder and hand movement was greatly improved.Barthel index scores were increased from 80 to 100 and the CRPS Severity Scale scores were decreased from 12 to 1.Comprehensive rehabilitation treatment has a good effect on the patient with CRPS after rotator cuff injury,and the patient has returned to a normal family life.

关 键 词：肩袖损伤 复杂性区域疼痛综合征 物理疗法 

分 类 号：R745[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]