4. 4. 4. 4. 这是一个很棒的节目. 疼痛的糖尿病多神经病变.
Xander Zuidema1,2, Bastiaan de Galan3,4,5, Brigitte Brouwer1
1Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
Pain practice : the official journal of World Institute of Pain
|October 20, 2023
概括
疼痛性糖尿病多神经病变 (PDPN) 诊断正在转向个性化表型和基因型. 对PDPN的治疗应以机制为基础,从适当的血糖控制和风险因素预防开始.
科学领域:
- 神经学 神经学
- 糖尿病学 糖尿病学
- 疼痛管理 疼痛管理
背景情况:
- 疼痛性糖尿病多神经病变 (PDPN) 显著影响患者的生活质量并增加死亡率.
- 近几十年来,PDPN的发病率大幅上升,凸显了其日益增长的公共卫生重要性.
研究的目的:
- 审查和总结有关糖尿病多神经病症 (DPN) 诊断和治疗的当前文献.
- 概述PDPN管理的不断发展的策略,强调精准医学方法.
主要方法:
- 对糖尿病多神经病症的诊断和治疗进行了全面的文献审查.
- 信息进行了综合,以提供当前和新兴临床实践的概述.
主要成果:
- PDPN的病因是复杂的,涉及到外周感应器损伤和改变的中央疼痛调制.
- 诊断和治疗越来越多地根据个体患者的特征进行定制,包括表型和基因型.
- 建议早期基于机制的药理治疗,以及血糖控制和风险因素管理.
- 当标准治疗失败时,可以考虑先进的疗法,如脊髓刺激 (SCS) 和神经刺激技术.
结论:
- 诊断PDPN正在向个性化护理的表型和基因型发展.
- 对PDPN的治疗策略应基于机制,并应及时启动.
相关概念视频
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
14
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
14
Peripheral Artery Disease IV: Nursing Management
11
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
11
Chronic Pancreatitis I: Introduction
95
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
95
Peripheral Artery Disease I: Introduction
9
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
9
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Blood and Nerve Supply to the Bones
11.1K
Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
11.1K


