Siemionow Maria, Alghoul Mohammed, Molski Michal, Agaoglu Galip
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Ann Plast Surg. 2006 Oct;57(4):385-90. doi: 10.1097/01.sap.0000221979.13847.30.
Surgical decompression of peripheral nerves in patients with diabetes was reported to restore sensation and improve function. In this study, a retrospective review of 12 diabetic and 20 nondiabetic patients with lower-extremity peripheral neuropathy who underwent surgical decompression was performed. Clinical evaluation by Tinel test, muscle power examination, and 2-point discrimination were performed preoperatively, at 6 months, and between 9 and 15 months postdecompression. Clinical outcomes were classified into excellent, good, or fair based on improvement in symptoms and return of function. Thirty-two patients underwent 36 surgeries, in which 99 lower-extremity nerves were decompressed. There was a statistically significant improvement in muscle function (P < 0.001) and 2-point discrimination for the small toe (P = 0.008) and big toe (P = 0.038). At a mean of 7.7 months, 90% of patients showed significant improvement in pain and function. It is concluded that surgical decompression was associated with significant improvement in clinical outcome in patients with diabetic and idiopathic neuropathy with evidence of superimposed compression.
据报道，对糖尿病患者进行外周神经手术减压可恢复感觉并改善功能。在本研究中，对12例糖尿病和20例非糖尿病的下肢周围神经病变患者进行了手术减压的回顾性分析。术前、术后6个月以及减压后9至15个月进行了Tinel试验、肌力检查和两点辨别觉的临床评估。根据症状改善和功能恢复情况，将临床结果分为优、良或可。32例患者接受了36次手术，其中99条下肢神经得到减压。肌肉功能（P < 0.001）以及小趾（P = 0.008）和大趾（P = 0.038）的两点辨别觉有统计学意义的改善。平均7.7个月时，90%的患者疼痛和功能有显著改善。结论是，对于有叠加压迫证据的糖尿病和特发性神经病变患者，手术减压与临床结果的显著改善相关。
