Dominkus M, Bauer R, Kepplinger B, Malikpur G
Chirurgie Krankenhaus Tulln.
Vasa Suppl. 1990;30:152-6.
Thirty patients with inoperable diabetic angiopathies (degree III and IV concerning to Fontaine) were treated by means of percutanous radiofrequency thermolesion of the lumbar sympathetic chain (PRFS). All patients reported immediately after this procedure a distinct feeling of warmth in the treated leg. After a period of 6 month to two years 22 patients were re-examined clinically: Fifteen patients changed to Fontaine IIa and ten patients were free of further complaints. Also an improved wound healing and ulcer demarcation following amputation or skin transplantation was observed. The advantage of PRFS in comparison to the surgical sympathectomy is the fact that there is no general anesthesia necessary, which too minimizes the risk especially for the aged vascular patient. Moreover the patient can be mobilised immediately after the procedure. There were no complications like lesion of the ureter or the genitofemoral nerve as well as bleading into the psoas muscle as reported in percutanous chemical lesion of the sympathetic chain.
30例患有无法手术的糖尿病血管病变(根据Fontaine分级为III级和IV级)的患者接受了经皮腰椎交感神经链射频热凝术(PRFS)治疗。所有患者在该手术后立即报告治疗侧腿部有明显的温热感。在6个月至2年的时间段后,对22例患者进行了临床复查:15例患者病情改善至Fontaine IIa级,10例患者无进一步不适。还观察到截肢或皮肤移植后伤口愈合及溃疡界限改善。与手术交感神经切除术相比,PRFS的优势在于无需全身麻醉,这也将风险降至最低,尤其对于老年血管疾病患者。此外,患者术后可立即活动。未出现如交感神经链经皮化学毁损术所报告的输尿管或生殖股神经损伤以及腰大肌内出血等并发症。