《中国康复理论与实践》

中国康复理论与实践 >

2020 , Vol. 26 >Issue 2: 232 - 236

DOI: https://doi.org/10.3969/j.issn.1006-9771.2020.02.017

临床观察

重复经颅磁刺激联合常规康复对桡骨远端骨折后复杂区域性疼痛综合征I型患者上肢功能影响1例报道

  • 古丽加克拉·艾山 ,
  • 陈婵 ,
  • 高天昊 ,
  • 凌骏麒 ,
  • 孙莉敏 ,
  • 白玉龙
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  • 复旦大学附属华山医院康复医学科,上海市 200040
古丽加克拉•艾山(1987-),女,维吾尔族,新疆乌鲁木齐市人,硕士,医师,主要研究方向:运动伤病和内科疾病康复。

收稿日期: 2019-01-14

  修回日期: 2019-05-05

  网络出版日期: 2020-03-19

基金资助

1.上海市科学技术委员会科研项目(15441900803);上海市科学技术委员会科研项目(17511107802);2.宝山区科技创新专项资金项目(17-E-31)

收起

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Conventional Rehabilitation on Upper Extremity Function for A Patient with Complex Regional Pain Syndrome I after Distal Radius Fracture

  • Ai-shan GULIJIAKELA ,
  • Chan CHEN ,
  • Tian-hao GAO ,
  • Jun-qi LING ,
  • Li-min SUN ,
  • Yu-long BAI
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  • Department of Rehabilitation, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China

Received date: 2019-01-14

  Revised date: 2019-05-05

  Online published: 2020-03-19

Supported by

Shanghai Science and Technology Committee Research Program(15441900803);Shanghai Science and Technology Committee Research Program(17511107802);Special Fund for Scientific and Technological Innovation in Baoshan District(17-E-31)

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摘要

目的 探讨左侧桡骨远端骨折后并发复杂区域性疼痛综合征(CRPS)患者的发生发展以及重复经颅磁刺激(rTMS)联合常规康复的疗效。方法 对1例患者采用rTMS联合常规康复治疗3周。采用视觉模拟评分(VAS)评价疼痛,测量手体积和手指周径测量评价水肿情况,并测量被动关节活动度,采用改良Barthel指数评价日常生活活动能力。结果 治疗前,患者VAS评分8分,左手容积330 ml,皮温36.8 ℃,左侧肘关节前屈、伸展,左前臂旋前、旋后,左侧腕关节屈曲、伸展、尺侧偏、桡侧偏,左手掌指关节(MCP),近段指间关节(PIP),远端指间关节(DIP)活动均受限,左侧手指周径明显大于右侧,改良Barthel指数85分。3周后,患者VAS疼痛评分2分,左手容积310 ml,皮温33.8 ℃,左侧肘关节,左侧腕关节及左侧MCP、PIP、DIP关节活动度均较前好转,改良Barthel指数100分。结论 采用rTMS联合常规康复治疗桡骨远端骨折后CRPS患者取得较好的疗效,患者左上肢关节活动度、水肿程度明显好转,日常生活活动能力提高。

关键词： 桡骨远端骨折; 复杂区域性疼痛综合征; 重复经颅磁刺激

本文引用格式

古丽加克拉·艾山 , 陈婵 , 高天昊 , 凌骏麒 , 孙莉敏 , 白玉龙 . 重复经颅磁刺激联合常规康复对桡骨远端骨折后复杂区域性疼痛综合征I型患者上肢功能影响1例报道[J]. 中国康复理论与实践, 2020 , 26(2) : 232 -236 . DOI: 10.3969/j.issn.1006-9771.2020.02.017

Abstract

Objective To summarize the development of a patient with complex regional pain syndrome (CRPS) after distal radius fracture and the effect of repetitive transcranial magnetic stimulation (rTMS) combined with conventional rehabilitation on it.Methods One patient with CRPS after left distal radius fracture was treated with rTMS combined with conventional rehabilitation for three weeks. The pain degree was evaluated with Visual Analogue Score (VAS), the edema was assessed with volume of hand and circumference of finger, and motion of joint was measured with passive range of motion. The activities of daily living was assessed with modified Barthel Index (MBS).Results Before treatment, the VAS score was 8, the volume of left hand was 330 ml, the temperature of skin was 36.8 ℃. The activity of flexion and extension of left elbow joint, pronation and supination of left forearm, the flexion, extension, ulnar deviation and temporal deviation of left wrist, and metacarpophalangeal joints (MCP), proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP) of left hand were all limited. The circumference of left finger was larger than right finger, and the score of MBI was 85. After three weeks of treatment, the VAS score was 2, the volume of the left hand was 310 ml, the temperature of the skin was 33.8 ℃. The activities of left elbow joint, left wrist joint and left MCP, PIP, and DIP were better than before. The score of MBI was 100.Conclusion rTMS combined with conventional rehabilitation is effective on CRPS after distal radius fracture, in the range of motion and edema of upper extremity, and activities of daily living.

Key words： distal radius fracture; complex regional pain syndrome; repetitive transcranial magnetic stimulation

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