在不可重建的关键四肢威胁性缺血症中对外围神经刺激:一系列病例
Justin G James1, Jack K Burch1, Sreyansh Rishabh2
1From the Department of Anesthesia and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
A&A practice
|January 6, 2026
概括
周围神经刺激 (PNS) 为一些患有慢性四肢威胁性缺血症 (CLTI) 的患者提供疼痛缓解和延迟大截肢,当再血管化不是一种选择时. 这种方法可能有助于暂时保存四肢.
科学领域:
- 血管外科 血管外科
- 疼痛管理 疼痛管理
- 神经调节是一种神经调节.
背景情况:
- 慢性四肢威胁性缺血症 (CLTI) 通常会导致严重的疼痛.
- 对所有CLTI患者来说,再血管是不可行的.
- 在CLTI中,重大截肢通常是耐火性疼痛的唯一治疗选择.
研究的目的:
- 为了评估超声导向外周神经刺激 (PNS) 缓解疼痛的疗效.
- 评估PNS在非可重建的CLTI患者肢体保存方面的潜力.
主要方法:
- 包括10名患有严重外周动脉疾病和不可重建的CLTI的患者.
- 腿部和坐骨神经的超声指导PNS进行了镇痛.
- 记录了关于疼痛管理和截肢需要的结果.
主要成果:
- 两名患者成功避免了严重的截肢.
- 八名患者经历了截肢,PNS植入后的中位数为33天.
- 在某些情况下,PNS提供了疼痛缓解和临时肢体保护.
结论:
- 周围神经刺激 (PNS) 可能为CLTI患者的疼痛管理提供一个可行的选择.
- 在精选的CLTI病例中,PNS可能会推迟需要进行重大截肢.
- 需要进一步的研究来证实PNS在CLTI的肢体救援中的作用.
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