复杂局部疼痛综合征合并下肢继发性淋巴水肿1例的治疗体会。

Ji Hee Hong, Seung Ju Kim
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摘要

背景:淋巴水肿的特点是局部组织肿胀,由于过多的淋巴间隙潴留。淋巴水肿很容易被误诊,因为它类似于四肢肿胀的其他情况。我们报告一例伴有继发性淋巴水肿的复杂区域性疼痛综合征(CRPS) I型患者,通过脊髓刺激(SCS)成功治疗。病例:一名39岁的女性患者以下肢疼痛和水肿主诉来到我们的疼痛门诊。为查明下肢水肿的原因,行下肢血管造影及血液检查。然而,所有的评估都是正常的。最后行淋巴显像显示继发性淋巴水肿。我们进行了神经干细胞移植,发现神经干细胞移植后神经干细胞的功能显著降低。结论:我们可以成功地治疗CRPS合并淋巴水肿的顽固性疼痛和水肿。如果患者出现不同性质的水肿,则需要考虑其他疾病的共存。
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Treatment experience in a patient of complex regional pain syndrome combined with secondary lymphedema of lower extremity.

Background: Lymphedema is characterized by localized tissue swelling due to excessive interstitial space retention of lymphatic fluid. Lymphedema is easy to be misdiagnosed since itresembles other conditions of extremity swelling. We present a case of complex regionalpain syndrome (CRPS) type I with secondary lymphedema that was successfully managedwith spinal cord stimulation (SCS).

Case: A 39-year-old female patient came to our pain clinic with complaints of lower extremity pain and edema. To find out reason of leg edema, computed tomography of extremity angiography and blood test were performed. However, all of evaluations were normal. Lastlyperformed lymphoscintigraphy showed secondary lymphedema. SCS was performed and itshowed dramatic reduction subsequent to implantation of SCS.

Conclusions: We could successfully manage the intractable pain and edema in CRPS combined with lymphedema. If a patient presents different nature of edema, coexistence of other disease needs to be considered.

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