脊髓刺激在国际指导方针中的哪个地方适合耐火性疼痛性糖尿病神经病变? 一个共识声明,一个共识声明
A J M Boulton1, T S Jensen2, T Luecke3
1University of Manchester, Manchester, UK.
Diabetes research and clinical practice
|January 20, 2024
概括
对于耐火性疼痛性糖尿病神经病变 (PDN),不建议使用阿片类药物. 脊髓刺激 (SCS),特别是高频 SCS (10 kHz),对于对其他疗法无反应的患者来说,是一种有效和安全的治疗选择.
科学领域:
- 神经学 神经学
- 疼痛管理 疼痛管理
- 内分泌学 在内分泌学.
背景情况:
- 疼痛性糖尿病神经病变 (PDN) 通常会对标准药物治疗产生耐药性.
- 对PDN的第一线和二线治疗可能会产生显著的副作用.
- 第三线选择包括阿片类药物,素8%贴片和脊髓刺激 (SCS).
研究的目的:
- 为治疗耐火PDN建立共识建议.
- 评估第三线治疗选择的疗效和安全性.
- 为SCS.提供有关适当患者选择的指导.
主要方法:
- 专家小组于2022年12月10日召开会议.
- 九位专家 (糖尿病,疼痛,卫生服务) 审查了现有数据.
- 在数据审查和讨论后达成口头共识.
主要成果:
- 阿片类药物是耐火性PDN的高风险,短期选择,应该避免使用.
- 脊髓刺激 (SCS) 是对精选患者的一种有效,安全和持久的治疗方法.
- 高频 SCS (10 kHz) 显示出强大的疗效并改善生活质量.
结论:
- 对于耐火性,严重的PDN而言,阿片类药物的使用在全球范围内应该很少见.
- 脊髓刺激 (SCS),特别是高频SCS,建议用于PDN耐火的第一和二线疗法.
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