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ORIJINAL ARAŞTIRMA

Kompleks Bölgesel Ağrı Sendromlu Hastaların Demografik ve Klinik Özellikleri: Üçüncü Basamak Tecrübesi
The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience
Received Date : 07 Nov 2019
Accepted Date : 18 Feb 2020
Available Online : 20 Feb 2020
Doi: 10.31609/jpmrs.2019-72270 - Makale Dili: EN
J PMR Sci. 2020;23(3):152-7
ÖZET
Amaç: Bu çalışmanın amacı, kompleks bölgesel ağrı sendromlu (KBAS) hastaların demografik ve klinik özelliklerini belirleyerek KBAS’ın epidemiyolojik özelliklerini açığa çıkarmaktır. Gereç ve Yöntemler: Çalışmaya, Ocak 2010 ve Aralık 2018 tarihleri arasında kliniğimizce takip edilen KBAS tanılı 88 hasta dahil edildi. Hastalar retrospektif olarak demografik özellikler, semptom karakteristikleri (duyusal, vazomotor, sudomotor/ödem ve motor/trofik), tutulan ekstremite ve etkilenen taraf, etyolojik faktörler (ortopedik cerrahi öyküsü, yumuşak doku travması, inme, immobilizasyon, alçı kullanımı), olası risk faktörleri (sigara kullanımı, menopoz, migren, osteoporoz, astım ve anksiyete bozukluğu) ve kullanılan tedavi yöntemleri açısından değerlendirildi. Bulgular: Yaş ortalaması 51,14±15,25 yıl (min: 18, maks: 82) idi. Hastaların %60,2 (n: 53)’sinde üst ekstremite tutulumu vardı ancak etkilenen taraf açısından istatistiksel olarak anlamlı bir fark yoktu (p: 0,754). Yumuşak doku travmaları her iki cinsiyette de etyolojideki en sık faktördü. Hastalar en fazla duyusal semptomlar ile başvurmuşlardı. Kadınlarda belirlenen en sık risk faktörü menopoz iken erkeklerde ise sigara kullanımı idi. Hastaların %56,8 (n: 50)’inde alçıda kalma öyküsü varken ortalama alçıda kalma süresi 41,60±11,33 gün (min: 20 gün; maks: 70 gün) idi. Hastaların %63.6 (n: 56)’sı fizik tedavi programına alınırken; ortalama seans sayısı 33,42±10,70 (min: 20 seans; maks: 60 seans) idi. Alçıda kalma süresi ile fizik tedavi seans sayısı arasında istatistiksel olarak anlamlı pozitif bir korelasyon var idi (r: 0,571, p<0,001). Sonuç: Çalışmamızın sonuçları KBAS’ ın, her iki cinsiyeti ve farklı yaş gruplarını etkileyebilen bir hastalık olduğunu, üst ekstremitenin alt ekstremiteye göre daha fazla etkilendiğini; etyolojide belirlenen en sık etkenin yumuşak doku travmaları olduğunu göstermektedir. Kadınlarda menopoz, erkeklerde ise sigara kullanımı belirlenen en sık iki risk faktörü idi. Hastalığın epidemiyolojik özelliklerinin belirlenerek riskli hastaların öngörülebilmesi, erken tanı ve tedaviyi mümkün kılacaktır.
ABSTRACT
Objective: The aim of our study was to determine the demographic and clinical characteristics of the patients with complex regional pain syndrome (CRPS) and to reveal the epidemiological features of CRPS. Material and Methods: Eighty-eight patients with CRPS, admitting to our clinic between January 2010 and December 2018 were included in the study. Patients were evaluated retrospectively in terms of demographics, symptom characteristics (sensory, vasomotor, sudomotor/edema and motor/trophic), involved extremity and side; etiological factors (orthopedic surgery history, soft tissue trauma, stroke, immobilization, cast using), possible risk factors (smoking, menopause, migraine, osteoporosis, asthma and anxiety disorders) and used therapeutic modalities. Results: Mean age of the patients was 51.14±15.25 years (min:18, max: 82). In 60.2% (n: 53) of the patients, upper extremity was involved but there was no statistically significant difference in terms of the involved side (p: 0.754). Soft tissue traumas were the most common factor in etiology in both genders. Most of the patients presented with sensory symptoms. The most common risk factor was menopause in females and smoking in males. Fifty patients (56.8%) had a history of cast using and the mean duration of cast using was 41.60±11.33 days (min: 20 days; max: 70 days). While 63.6% (n: 56) of the patients were included in a physical therapy program; the mean number of the physical therapy sessions was 33.42±10.70 (min: 20 sessions; max: 60 sessions). There was a statistically significant positive correlation between the duration of cast using and the number of physical therapy sessions (r: 0.571, p <0.001). Conclusion: The results of our study suggest that CRPS can affect both genders and different age groups, and that the upper extremity is involved more than the lower extremity. The most common etiological factor is soft tissue traumas. Menopause in females and smoking in males were the two most common risk factors. The determination of the epidemiological characteristics of the patients with CRPS will enable to predict the risky patients and early diagnosis and treatment of the disease.
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