Surgical decompression of painful diabetic peripheral neuropathy: the role of pain distribution.
Surgical decompression of painful diabetic peripheral neuropathy: the role of pain distribution.
复制标题
疼痛性糖尿病周围神经病变的手术减压：疼痛分布的作用
DOI：
10.1371/journal.pone.0109827
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhong W
中科院分区：
文献类型：
--
作者：
Liao C;Zhang W;Yang M;Ma Q;Li G;Zhong W
目的探讨手术减压对疼痛性糖尿病周围神经病变（DPN）患者的治疗效果，探讨疼痛分布和特征在疼痛性DPN治疗中的作用及其机制。方法对306例疼痛性糖尿病下肢神经病变患者行delon手术神经减压术。临床评价包括视觉模拟量表（VAS）、糖尿病周围神经病变简短疼痛量表（BPI-DPN）问卷、两点辨别（2- pd）、神经传导速度（NCV）和高分辨率超声（横截面积，CSA），所有病例术前及术后2年每隔6个月进行一次。根据糖尿病神经性疼痛的分布，回顾性地将手术患者分为局灶性疼痛和弥漫性疼痛两组。对照组包括92例未手术的疼痛DPN患者。结果手术组患者VAS评分、BPI-DPN评分、2-PD评分、NCV评分及CSA评分均较对照组改善（P<0.05）。局灶性疼痛组VAS评分、BPI-DPN评分、CSA评分较弥漫性疼痛组明显改善（P<0.05）。结论对疼痛性糖尿病神经病变患者行下肢多处周围神经减压术疗效确切。局灶组和弥漫性组均可受益于手术减压，但局灶组疼痛缓解和形态恢复效果更好。
Objective To investigate the effect of surgical decompression on painful diabetic peripheral neuropathy (DPN) patients and discuss the role which pain distribution and characterization play in the management of painful DPN as well as the underlying mechanism involved. Methods A total of 306 patients with painful diabetic lower-extremity neuropathy were treated with Dellon surgical nerve decompression in our department. Clinical evaluation including Visual analogue scale (VAS), Brief Pain Inventory Short Form for diabetic peripheral neuropathy (BPI-DPN) questionnaire, two-point discrimination (2-PD), nerve conduction velocity (NCV) and high-resolution ultrasonography (cross-sectional area, CSA) were performed in all cases preoperatively, and at 6 month intervals for 2 years post-decompression. The patients who underwent surgery were retrospectively assigned into two subgroups (focal and diffuse pain) according to the distribution of the diabetic neuropathic pain. The control group included 92 painful DPN patients without surgery. Results The levels of VAS, scores in BPI-DPN, 2-PD, NCV results and CSA were all improved in surgical group when compared to the control group (P<0.05). More improvement of VAS, scores in BPI-DPN and CSA was observed in focal pain group than that in diffuse group (P<0.05). Conclusions Efficacy of decompression of multiple lower-extremity peripheral nerves in patients with painful diabetic neuropathy was confirmed in this study. While both focal and diffuse group could benefit from surgical decompression, pain relief and morphological restoration could be better achieved in focal group.
登录
查看更多内容
影响因子：
8.2
作者：
JAKOBSEN, J
通讯作者：
JAKOBSEN, J
影响因子：
8
作者：
Quattrini, C;Tesfaye, S
通讯作者：
Tesfaye, S
影响因子：
16.2
作者：
Abbott CA;Malik RA;van Ross ER;Kulkarni J;Boulton AJ
通讯作者：
Boulton AJ
影响因子：
1.5
作者：
Siemionow, Maria;Alghoul, Mohammed;Agaoglu, Galip
通讯作者：
Agaoglu, Galip
影响因子：
168.9
作者：
Eaton, SEM;Harris, ND;Tesfaye, S
通讯作者：
Tesfaye, S