在内静脉激光切除术中对外围神经损伤的定量评估,包括或不包括微切除术:对25例病例的前性队列研究
Atsushi Hiromoto1, Shun-Ichiro Sakamoto1, Kenji Suzuki1
1Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.
Annals of vascular diseases
|December 27, 2024
概括
外周神经损伤 (PNI) 可能发生在使用内静脉激光切除 (EVLA) 的静脉静脉 (VV) 手术后,特别是在进行微切除术时. 大多数伤害都是暂时的,在六个月内就会消失.
科学领域:
- 血管外科 血管外科
- 神经学 神经学
- 再生医学是一种再生医学.
背景情况:
- 静脉静脉 (VV) 手术很常见,内静脉激光切除 (EVLA) 是一种最少的侵入性方法.
- 周围神经损伤 (PNI) 是血管手术后的潜在并发症.
- 在EVLA后对PNI的定量评估对于了解患者的结果至关重要.
研究的目的:
- 量化评估静脉瘤内静脉激光切除术 (EVLA) 后外周神经损伤 (PNI) 的发生率和严重程度.
- 评估EVLA手术后神经功能的时间恢复.
- 在接受VV手术的患者中识别与PNI相关的因素.
主要方法:
- 一项前性研究,涉及25名接受大沙静脉EVLA的患者,有或没有微切除术.
- 当前感知值 (CPT) 测量每条腿6个点,在手术前和手术后1周,1个月,3个月,6个月.
- 从基线看,PNI被定义为CPT>40%的增加;统计分析确定了相关因素.
主要成果:
- 在EVLA1周后,在膝关节和上下腿部观察到显著的CPT升高,表明PNI (分别P=0.01和P=0.008).
- 术后6个月CPT值正常化,表明过渡性神经损伤.
- 在52%的患者中,PNI发生在膝盖和36%的患者在上下腿部;同时进行的微切除术与PNI显著相关 (P<0.01).
结论:
- 静脉静脉激光切除与短暂的外周神经损伤的显著发生率有关,特别是与微切除术相结合时.
- 在EVLA之后的早期术后PNI通常是暂时的,在六个月内观察到功能恢复.
- 这些发现强调了在EVLA手术中考虑微切除术作为PNI的风险因素的重要性.
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