脊髓神经调节用于下肢外周动脉疾病:十年后期分析
Michael Kretzschmar1, Udoka Okaro2, Marcus Schwarz3
1Department of Pain Medicine and Palliative Care, SRH Wald-Klinikum Gera, Gera, Germany; SRH University of Applied Health Sciences Gera, Campus Gera, Gera, Germany.
概括
脊髓神经调节显著改善四肢救援,缓解疼痛和外周动脉疾病 (PAD) 患者的运动能力. 这种疗法提供了长期的好处,减少截肢和阿片类药物用于慢性四肢疼痛.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 疼痛管理 疼痛管理
背景情况:
- 周围动脉疾病 (PAD) 通常会导致严重的慢性四肢疼痛,导致运动能力减弱和截肢.
- 神经调节提供了一个潜在的治疗方法来管理耐火性PAD症状.
研究的目的:
- 评估与脊髓神经调节治疗的PAD患者的长期生存和截肢结果.
- 评估神经调节对PAD患者疼痛,生活质量,步行距离和阿片类药物使用的影响.
主要方法:
- 在2007年至2022年期间,对51名PAD患者进行了脊髓刺激 (SCS) 或背部根结节刺激 (DRG-S) 的回顾性分析.
- 评估生存,主要截肢率,疼痛,生活质量,步行距离和阿片类药物使用在基线和随访间隔长达10年的评估.
主要成果:
- 在24个月后,47名患者中有42人避免了重大截肢.
- 所有患者报告说,休息时几乎完全缓解疼痛.
- 观察到步行距离的显著改善 (>200米为75%),阿片类药物使用的显著减少 (87%的减少).
结论:
- 脊髓神经调节对于挽救四肢,减少疼痛和改善PAD患者的功能是有效的.
- 该疗法在Rutherford类3-5 PAD中对慢性四肢疼痛表现出持续的长期治疗效果.
相关概念视频
Peripheral Artery Disease I: Introduction
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, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
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...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Peripheral Artery Disease IV: Nursing Management
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, temperature changes,...
Peripheral Artery Disease V: Postoperative Nursing Management
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...


