Liu Y, Wang Q S, Wan C F, Wang K P, Song T
Department of Pain Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Yi Xue Za Zhi. 2021 Nov 23;101(43):3559-3563. doi: 10.3760/cma.j.cn112137-20210729-01685.
To observe the clinical efficacy of spinal cord stimulation (SCS) in the treatment of diabetic foot (DF). Sixteen patients who were diagnosed with DF and treated with SCS from the Department of Pain Medicine of the First Affiliated Hospital, China Medical University from October 2015 to October 2018 were retrospectively analyzed. Visual analogue scale (VAS), 36-item short form health survey (SF-36), transcutaneous oxygen partial pressure (TcPO) and skin temperature of lower limbs were compared before and after treatment, and the complications were recorded. Among the 16 patients, 14 were equipped with implantable pulse generator (IPG). The VAS scores decreased significantly from 7.5±1.2 before treatment to 2.6±0.8, 2.0±0.7, 1.6±0.6, 1.0±0.9, 0.9±0.9 at 1 day, 1 week, 3 months, 6 months and 12 months after electrode implantation respectively (all 0.05). At 12 months after treatment, the parameters of SF-36 were significantly different from those before treatment (all 0.05). The TcPO was (23±5) mmHg before treatment and (38±6) mmHg at 1 week after treatment, with a statistical difference (0.05), and the temperature of lower limbs increased significantly (<0.05). No serious complications were observed in all patients. SCS can relieve the pain of patients with DF, improve the microcirculation and blood supply of lower limbs, and thus promote the quality of life, with rare serious complications.
观察脊髓刺激(SCS)治疗糖尿病足(DF)的临床疗效。回顾性分析2015年10月至2018年10月在中国医科大学附属第一医院疼痛医学科确诊为DF并接受SCS治疗的16例患者。比较治疗前后的视觉模拟评分(VAS)、36项简明健康调查问卷(SF-36)、经皮氧分压(TcPO)和下肢皮肤温度,并记录并发症。16例患者中,14例植入了植入式脉冲发生器(IPG)。电极植入后1天、1周、3个月、6个月和12个月时,VAS评分分别从治疗前的7.5±1.2显著降至2.6±0.8、2.0±0.7、1.6±0.6、1.0±0.9、0.9±0.9(均P<0.05)。治疗12个月时,SF-36各项参数与治疗前相比差异有统计学意义(均P<0.05)。治疗前TcPO为(23±5)mmHg,治疗后1周为(38±6)mmHg,差异有统计学意义(P<0.05),下肢温度显著升高(P<0.05)。所有患者均未观察到严重并发症。SCS可缓解DF患者的疼痛,改善下肢微循环和血液供应,从而提高生活质量,严重并发症罕见。