Adar R, Meyer E, Zweig A
Ann Surg. 1979 Nov;190(5):609-13. doi: 10.1097/00000658-197911000-00008.
Although relatively frequent in our experience saphenous neuralgia (SN) is not usually reported as a complication of vascular operations below the inguinal ligament. In 55 patients undergoing extended deep femoral angioplasty (EDFA, n = 28) and femoropopliteal bypass graft (FPBG, n = 27) special attention was paid to incidence and severity of postoperative SN. Severe early postoperative SN was seen in 8/28 patients with EDFA and in 6/27 with FPBG. Milder SN was seen in 10 more patients with EDFA, and 3 other developed SN many months after surgery. The milder forms of SN and late SN were not encountered after FPBG. SN usually improved with the passage of time, and at last follow-up averaging 18 months for EDFA and 33 months for FPBG there remained only 23 patients with mild SN (15 after EDFA and 8 after FPBG). The etiology of SN appears to be trauma to the nerve sustained during operation. Age, sex, diabetes, or the addition of lumbar sympathectomy to the vascular operation did not affect the risk of sustaining early postoperative SN. Increased awareness of this complication may help to understand its pathophysiology better, and possibly to decrease its incidence.
尽管在我们的经验中隐神经痛（SN）相对常见，但它通常未被报道为腹股沟韧带以下血管手术的并发症。在55例行股深动脉血管成形术（EDFA，n = 28）和股腘动脉搭桥术（FPBG，n = 27）的患者中，特别关注了术后SN的发生率和严重程度。EDFA组28例患者中有8例出现严重的术后早期SN，FPBG组27例患者中有6例出现。EDFA组另有10例患者出现较轻的SN，还有3例在术后数月出现SN。FPBG术后未出现较轻形式的SN和迟发性SN。SN通常会随着时间推移而改善，在EDFA平均随访18个月、FPBG平均随访33个月时，仅有23例患者仍有轻度SN（EDFA术后15例，FPBG术后8例）。SN的病因似乎是手术期间神经受到的创伤。年龄、性别、糖尿病或在血管手术中加做腰交感神经切除术均不影响术后早期发生SN的风险。提高对该并发症的认识可能有助于更好地理解其病理生理学，并可能降低其发生率。
