作为神经重建成功的预测者,外围神经阻塞是大肢体截肢后的神经重建的成功
Daisy E Martinez1, Anthony G DeMartino1, Georg J Furtmüller2
1Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA.
Cureus
|October 16, 2024
概括
周围神经阻塞 (PNBs) 有效地识别那些将从截肢修复手术中受益的患者,如向肌肉再生 (TMR) 和再生周围神经接口 (RPNI),减少幻肢疼痛 (PLP). 这种诊断方法改善了研究参与者的疼痛和行走能力.
科学领域:
- 再生医学是一种再生医学.
- 疼痛管理 疼痛管理
- 神经外科 神经外科
背景情况:
- 截肢后疼痛 (PAP),包括幻肢疼痛 (PLP),显著影响数百万,通常源于神经瘤形成和中枢神经系统变化.
- 神经重建手术,如再生外围神经接口 (RPNI) 和向肌肉再生 (TMR),通过重定向神经纤维提供解决方案.
- 确定适合这些先进手术干预的候选人仍然是一个临床挑战.
研究的目的:
- 评估外科外围神经阻塞 (PNB) 作为诊断工具的实用性.
- 为了确定那些可能从RPNI或TMR手术中受益的截肢后疼痛患者.
主要方法:
- 对六名膝下截肢 (BKA) 患者 (58-80岁) 的回顾性病例系列分析.
- 在接受神经重建手术 (TMR和/或RPNI) 之前,患者接受了诊断外围神经阻塞 (PNB).
- 疼痛减轻,PLP发作和行走率在PNB后和手术后进行评估.
主要成果:
- 所有患者在诊断PNB后,经历了截肢后疼痛的减少,特别是PLP.
- 在TMR/RPNI后,所有患者报告PLP发作减少,其中两个患者实现了完全疼痛缓解.
- 出行率显著提高,从修订前的50%提高到修订后的83%.
结论:
- 外围神经阻塞作为一种有效的诊断方式来选择患者进行截肢修复手术.
- PNBs可以预测TMR或RPNI的显著益处,从而减少幻肢疼痛和改善移动性.
- 这种方法有助于优化患有残疾的截肢后疼痛的个体的手术结果.
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